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Kidney Week

Abstract: PO2580

Identifying the Causes for Kidney Allograft Failure

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • 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
Background

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.

Methods

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.

Results

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.

Conclusion

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.