Exploring the Complexity of Death-Censored Kidney Allograft Failure

• DOI: 10.1681/asn.2020081215
• Publication Date: 2021-04-21T14:54:04Z
• Authors: Manuel Mayrdorfer; Lutz Liefeldt; Kaiyin Wu; Birgit Rudolph; Qiang Zhang; Frank Friedersdorff; Nils Lachmann; Danilo Schmidt; Bilgin Osmanodja; Marcel G. Naik; Wiebke Duettmann; Fabian Halleck; Marina Merkel; Eva Schrezenmeier; Johannes Waiser; Michael Duerr; Klemens Budde
• Keywords: Adult; Graft Rejection; Male; Immunity, Cellular; Polyomavirus Infections; Cardio-Renal Syndrome; Databases, Factual; Calcineurin Inhibitors; Graft Survival; Middle Aged; Allografts; Kidney Transplantation; Immunity, Humoral; Medication Adherence; 3. Good health; Death; 03 medical and health sciences; 0302 clinical medicine; Humans; Kidney Failure, Chronic; Female; Immunosuppressive Agents; Aged

Few studies have thoroughly investigated the causes of kidney graft loss (GL), despite its importance.A novel approach assigns each persistent and relevant decline in renal function over lifetime a allograft to standardized category, hypothesizing that singular or multiple events finally lead GL. An adjudication committee three physicians retrospectively evaluated indication biopsies, laboratory testing, medical history all 303 GLs among 1642 recipients transplants between January 1, 1997 December 31, 2017 at large university hospital assign primary and/or secondary GL.In 51.2% patients, more than one cause contributed The most frequent leading failure were intercurrent 36.3% failures followed by T cell-mediated rejection (TCMR) 34% antibody-mediated (ABMR) 30.7%. In 77.9%, could be attributed GL, which ABMR was (21.5%). Many for GL identified, predominant varied time.GL is often multifactorial complex previously thought.