Korean J Transplant.  2023 Nov;37(Suppl 1):S123. 10.4285/ATW2023.F-7056.

Clinical course of graft failure after kidney transplantation investigated focusing on immune rejection

• Han HS
• Park SC

• KMID: 2551743
• DOI: http://doi.org/10.4285/ATW2023.F-7056

Abstract

Background
One of the most critical side effects after kidney transplantation is graft failure, and one of them is rejection. Although we have tried many treatments for graft failure and are trying to achieve better results, we still cannot completely prevent failure, and still difficult to cure. Graft failure can even have fatal prognosis. Therefore, in order to find the cause of graft failure and to find a more suitable treatment for it, we reviewed cases of graft failure after transplantation.
Methods
A retrospective review was performed on 1,958 patients who underwent kidney transplantation from 2006 to 2020. Patients with immune rejection were identified, and their medical history, test results, postoperative condition, and biopsy were investigated. In particular, the causes and treatment methods for rejection were identified with emphasis.
Results
A total of 437 cases showed graft failure, and many causes of failure were investigated as follows: rejection, recur, vascular problems, viral infection, and autoimmunity. Especially, antibody-mediated rejection (AMR) was found in 72 cases. There were four deaths, showing a mortality rate of 5.6%. When treating AMR, it was divided into a steroid alone method, a method combining steroid and other drugs, and a conservative care method without steroids.
Conclusions
Graft failure is one of the most critical side effects that can occur after transplantation. A representative one of failure is rejection, and the method of treating rejection is variety of treatments depending on the cause of rejection.