Observations on recovery of renal function following treatment for acute rejection

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
A O GaberT J Schroeder

Abstract

The characteristics of rejection and rejection response have not been systematically described in renal transplant recipients. The Efficacy Endpoints Conference Database contains characteristics from 953 episodes of rejection occurring at 19 North American, European, and Australian transplant centers. This database was used to profile renal transplant rejection episodes treated with primary steroid therapy, primary antilymphocyte antibody therapy, and rescue antilymphocyte antibody therapy. Primary steroid therapy was used in 88% of the rejection episodes. A successful response was more common in recipients without fever (72% v 61%; P < 0.004), in recipients experiencing less than a Banff Grade III rejection (92% v 75%; P = 0.009), and was more likely associated with graft function at 1 year following the rejection than rejection episodes that failed steroid therapy (89% v 82%; P = 0.013). Steroid success was statistically identifiable by day 2 of therapy and clinically useful by day 3; serum creatinine on these days of therapy is shown as a ratio of the rejection creatinine (102% v 112% day 1, success v failure, P< 0.002; 104% v122% day 2, success v failure, P < 0.0001; 105% v125% day 3, success vfailure, P < 0.0001). Response...Continue Reading

Citations

Sep 21, 2002·Ambulatory Pediatrics : the Official Journal of the Ambulatory Pediatric Association·William O CooperWayne A Ray
Aug 12, 2000·Acta Anaesthesiologica Scandinavica·H J Toivonen
Feb 27, 2018·Canadian Journal of Kidney Health and Disease·Julie LeblancHéloïse Cardinal

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