J Korean Soc Transplant.
1997 May;11(1):49-54.
Risk Factors for Chronic Rejection in Renal Allograft Recipients
- Affiliations
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- 1Department of Internal Medicine, Keimyung University School of Medicine, Taegu, Korea.
- 2Department of Genera Surgery, Keimyung University School of Medicine, Taegu, Korea.
- 3Department of Urology, Keimyung University School of Medicine, Taegu, Korea.
- 4Department of Pathology, Keimyung University School of Medicine, Taegu, Korea.
Abstract
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Chronic rejection is a major barrier to long-term renal allograft survival. Cyclosporine, though effective at reducing the graft loss due to acute rejection, has had little impact on the incidence of chronic rejection. Between December 1984 and April 1995, 221 patients received a primary living donor kidney transplantation. In our study, 154 patients(70%) never had an episode of acute rejection, 22% had only one, and 8% had more the one. The incidence of chronic rejection was 12% in those who had no acute rejection, 39% in those with one or more rejection episode. The 5-year graft survival was 28% for recipients with biopsy-proven chronic rejection versus 83% for without(P<0.001). In an univariate analysis, donor age, serum creatinine level at 1 and 2 year post transplantation, cyclosporine dosage at year(<4 mg/kg vs >or=4 mg/kg) were significant risk factors for chronic rejection. In a logistic regression of multivariate analysis, we found that risk factors for chronic rejection were acute rejection episode(P<0.0001) and donor age(P<0.01).