Kidney transplantation (Tx) is the therapy of choice for end-stage renal disease. It
has been proven that the survival within transplanted patients, compared with dialysis
patients, is greater. However, it is known that several factors can influence the graft
outcome. One of them is the acute rejection, resulting from the innate and adaptive
immune responses to foreign donor antigens. However, no study has been
conducted to identify what are this factors in our centre yet.
In this study, we aim to update the database of the Lausanne/CHUV kidney
transplant recipients cohort in order to characterize this population. We intend to
identify the determinants associated with graft rejection and graft outcome at 1-year
post transplantation.
Clinical data are provided from the CHUV prospective databases from the day of Tx
to one year post Tx. We first performed a general analysis of all confounding factors
that we considered relevant based on recipients’ graft function at one year after Tx.
We studied then associations between immunological and clinical factor with acute
graft rejection. We finally compared acute cellular rejection (ACR) to acute antibody
mediated rejection (AMR).
After one year, the rate of acute rejection was 15.9% (47.5% ACR and 25% AMR).
Main found predictors tended to be related rather with acute AMR and reflected presensitization
(prior transplantation, positive last PRA values and pre-existing DSA).
Acute rejection was associated with decreased renal function (by around 14 ml/min of
GFR in the first year).