Abstract: FR-PO1228
Immunosuppression Management and Outcomes After Kidney Graft Failure
Session Information
- Transplantation: Clinical - Rejection, Biomarkers, and Pharmacology
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Poluyi, Abigail Oluwatumininu, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England, United Kingdom
- Obasanya, Ifeoluwapo Elizabeth, Bioluminux, Southampton, United Kingdom
- Chukwu, Chukwuma Austin, Royal Liverpool University Hospital, Liverpool, England, United Kingdom
Background
Immunosuppression management after kidney graft failure remains variable and may contribute to poor outcomes post dialysis. This study assessed immunosuppression management and outcomes in kidney transplant recipients (KTR) commencing dialysis.
Methods
We performed a single-centre retrospective exploratory observational study of KTR returning to dialysis after graft failure. Immunosuppression management, including timing of reduction/discontinuation, was evaluated. Outcomes included mortality, retransplantation, and chronic dialysis.
Results
Of 200 KTR identified, 79 with graft failure were included. Median age at dialysis commencement was 51 years (38–62), median time from transplantation to graft failure was 8 years (4–12).Tacrolimus-based therapy was used in 89% of KTR; 91% underwent CNI dose reduction. Antimetabolites were discontinued within 3 months in 23 (70%), while 10 (30%) continued > 3 months. Glucocorticoids were continued beyond 6 months in 22 (48%).Outcomes included retransplantation in 17 (22%), mortality in 25 (32%), and chronic dialysis in 37 (47%). 50% mortality occurred within 6.5 years of dialysis return. Longer immunosuppression exposure was associated with higher mortality (Fig 1B–D).
Conclusion
Prolonged immunosuppression exposure after dialysis recommencement may be associated with poorer survival post-graft failure.Further studies are required to define optimal immunosuppression withdrawal after graft failure.
Patient Characteristics and immunosuppression management following graft failure
| CHARACTERISTIC | VALUE |
| Patient, N | 79 |
| Age at transplant (years) | 41 (28-51) |
| Age at return to dialysis (years) | 51 (38-62) |
| Sex (Male) | 53 (67%) |
| Time from transplant to dialysis (years) | 8.0 (4.0-12.0) |
| CNI type (tacrolimus) | 70 (89%) |
| CNI dose reduction after dialysis | 72 (91%) |
| Antimetabolite discontinued within 3 months | 23 (70%) |
| Prednisolone discontinued after >6 months | 22 (48%) |
Values are presented as median (IQR) or n (%).