Silent acute rejection during prolonged delayed graft function reduces kidney allograft survival

Fawad Qureshi, Hamid Rabb, Bertram L. Kasiske

Research output: Contribution to journalArticle

Abstract

Background. The relationship between the effects of early, silent, acute rejection (AR) and delayed graft function (DGF) on kidney allograft survival remain controversial, and the role of protocol biopsies during DGF is unclear. We hypothesized that protocol biopsies during DGF would reveal a high incidence of silent AR that may adversely affect long-term allograft survival. Methods. We routinely carried out protocol biopsies in patients requiring dialysis 7 to 10 days posttransplant. We retrospectively examined the extent to which silent AR, diagnosed by protocol biopsies during prolonged DGF, may mediate the adverse effects of DGF on graft survival in 410 consecutive transplants using Cox proportional hazards analysis. Results. By 40 days posttransplant, the cumulative incidence of AR was 57.2% among 65 patients who had a protocol biopsies during DGF, while it was only 15.1% among the 345 who did not need a protocol biopsy. Mild DGF (n=30) requiring one or two dialysis treatments had no effect on graft survival, but the unadjusted risk ratio (and 95% confidence interval) associated with more prolonged DGF (n=104) was 3.08 (2.09-4.52, P

Original languageEnglish (US)
Pages (from-to)1400-1404
Number of pages5
JournalTransplantation
Volume74
Issue number10
StatePublished - Nov 1 2002

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Delayed Graft Function
Allografts
Kidney
Biopsy
Graft Survival
Dialysis
Incidence
Odds Ratio
Confidence Intervals
Transplants

ASJC Scopus subject areas

  • Transplantation
  • Immunology

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Silent acute rejection during prolonged delayed graft function reduces kidney allograft survival. / Qureshi, Fawad; Rabb, Hamid; Kasiske, Bertram L.

In: Transplantation, Vol. 74, No. 10, 01.11.2002, p. 1400-1404.

Research output: Contribution to journalArticle

Qureshi, Fawad ; Rabb, Hamid ; Kasiske, Bertram L. / Silent acute rejection during prolonged delayed graft function reduces kidney allograft survival. In: Transplantation. 2002 ; Vol. 74, No. 10. pp. 1400-1404.
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