Analysis of causes of graft loss in 135 kidney transplant recipients / 南方医科大学学报

OBJECTIVE@#To investigate the causes of graft loss in kidney transplant recipients.@*METHODS@#We retrospectively analyzed the clinical data of 135 recipients with graft loss after renal transplantation in the Eighth Medical Center of Chinese PLA General Hospital from January 1, 2002 to January 1, 2022.@*RESULTS@#A total of 135 kidney transplant recipients experienced graft failure. The causes of graft loss included graft rejection (70 cases, 51.8%), death of the recipients with functional graft (37 cases, 27.4%), surgical complications (12 cases, 8.9%), drug toxicity (4 cases, 3.0%), carbapenem-resistant Klebsiella pneumoniae infection (4 cases, 3.0%), polyoma BK virus-related nephropathy (3 cases, 2.2%), primary nonfunctioning kidney (2 cases, 1.5%), recurrence of primary disease (2 cases, 1.5%), and prerenal acute renal failure (1 case, 0.7%).@*CONCLUSION@#The main cause of graft loss after renal transplantation is graft rejection, and the secondary cause is death of the recipient with functional graft, and other reasons can be rare.

Correlation between anti-angiotensin type 1 receptor antibody and prognosis of sensitized renal transplant recipients / 中华器官移植杂志

Objective To evaluate the correlation between anti-angiotensin type 1 receptor (AT1R) antibody and the prognosis of HLA-positive sensitized renal transplant recipients.Methods Forty-three HLA-positive sensitized recipients positive for AT1R antibodies were tested.HLA antibodies were tested by Lurninex-based single antigen beads assay.AT1R antibody was detected by ELISA.The patients were divided into two groups according to AT1R antibody level:AT1R-AA positive group (AT1R-AA ≥9 U/mL,n =12) and AT1R-AA negative group (AT1R-AA＜9 U/mL,n =31).We also analyzed the rate of rejection and allograft loss,HLA antibodies level,kidney function,kidney survival and patients' survival,etc.Results The rate of allograft loss in the AT1RAA positive group and the AT1R-AA negative group was 41.7％ (5/12) and 9.6％ (3/31)respectively (P =0.02).The rate of AMR in the AT1R-AA positive group and the AT1R-AA negative group was 25％ (3/12) and 0.0％ (0/31) respectively (P =0.03).Meanwhile,the one-yearpatients' survival in the AT1R-AA positive group was lower than in the AT1R-AA negative group (P＜0.05).There was no significant association between AT1R-AA (mean AT1R-AA =8.7 U/mL)and MFI (mean MFI =9119).AT1R antibody was one of risk factors to acute antibody-mediated rejection and kidney allograft loss for sensitized recipients.Conclusion The rate of allograft loss in the AT1R-AA positive group and the AT1R-AA negative group was 41.7％ (5/12) and 9.6％ (3/31)respectively (P =0.02).The rate of AMR in the AT1R-AA positive group and the AT1R-AA negative group was 25％ (3/12) and 0.0％ (0/31) respectively (P =0.03).Meanwhile,the one-yearpatients' survival in the AT1R-AA positive group was lower than in the AT1R-AA negative group (P ＜0.05).There was no significant association between AT1R-AA (mean AT1R-AA =8.7 U/mL)and MFI (mean MFI =9119).AT1R antibody was one of risk factors to acute antibody-mediated rejection and kidney allograft loss for sensitized recipients.