A Retrospective Analysis on Reasons for Allograft Nephrectomy after Kidney Transplantation

Yi, Woon Yong; Son, Min Soo; Lee, Kil Yeon; Lee, Sang Mok; Koh, Suck Hwan; Hong, Sung Wha; Oh, Soo Myeong; Yoon, Choong; Park, Ho Chul; Yang, Moon Ho

Abstract

PURPOSE
Allograft nephrectomy has been done in considerable proportion due to many reasons after kidney transplantation. This study was undertaken to determine the incidence, causes, and time of allograft nephrectomy after kidney transplantation.
METHODS
A total 141 kidney transplantations were performed between 1993 and 2003 Kyung Hee University Hospital. We found 22 cases of allograft nephrectomy in the same period and a retrospective analysis was conducted on 22 allograft nephrectomy. The patients records were reviewed for age, causes, and time of allograft nephrectomy after kidney transplantation.
RESULTS
The pathological causes of allograft nephrectomy were chronic rejection in 18 cases (81.8%), acute rejection in 3 cases (13.6%), accelerated rejection in 2 cases (9.1%) and allograft infection, renal vessel thrombosis, cyclosporin toxicity, GVHD in each one case (4.5%). Of 18 cases with chronic rejection, acute rejection episode was occurred in 12 cases (66.7%). The interval from kidney transplantation to allograft nephrectomy was more than 5 years in most patients (63.6%).
CONCLUSION
In our studies, allograft nephrectomy was performed in 22 cases, chronic rejection was major cause of allograft nephrectomy, and acute rejection episide was occurred in most chronic rejection. We suggested that early detection and aggressive treatment of acute rejection might be considered to lower the incidence of allograft nephrectomy after kidney transplantation.