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Kidney Week

Abstract: PO2580

Identifying the Causes for Kidney Allograft Failure

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical


  • Mayrdorfer, Manuel, Charité Universitätsmedizin Berlin, Berlin, Germany
  • Naik, Marcel, Charité Universitätsmedizin Berlin, Berlin, Germany
  • Duettmann, Wiebke, Charité Universitätsmedizin Berlin, Berlin, Germany
  • Budde, Klemens, Charité Universitätsmedizin Berlin, Berlin, Germany

Since it has been proposed that several causes (C) can contribute to graft loss (GL), we analyzed transplant (Tx) recipients in our center and attributed a C to each persistent decline in renal function, finally leading to GL.


We retrospectively analyzed 1477 Tx, transplanted between 1997 and 2017 in a single center, of which 303 progressed to GL. An adjudication committee consisting of 3 physicians evaluated biopsies, laboratory data and medical history. Nonreversible decreases in renal function were attributed to primary and secondary C.


Overall graft survival for all patients is 93.7% for 1 year, 80% for 5 years and 60.6% for 10 years. The most frequent C leading to GL were intercurrent medical events in 36.3%, followed by T-cell mediated rejection (TCMR) in 34% and antibody-mediated rejection (ABMR) in 30.7% (table1). For primary C, ABMR (21.5%) was the leading C, followed by medical events (21.1%) and TCMR (12.9%). As expected, we observed an increasing relevance of ABMR in late GL (figure 1). Over 50% of GL had >1 C.


Analyzing GL, we observed that >50% were multifactorial. Our results show a significant role of TCMR in GL. Additionally, we were able to attribute medical events to GL in 36.3% of Tx and to highlight the role of ABMR in late GL.