ESPN 51th Annual Meeting

ESPN 2018


 
ACUTE REJECTION AND LONGTERM GRAFT SURVIVAL IN PEDIATRIC RENAL TRANSPLANT PATIENTS
ESRA BASKIN 1 KAAN GULLEROGLU 1 VILDAN SAHIN 1 OZLEM KAZANCI 1 GOKHAN MORAY 1 MEHMET HABERAL 1

1- BA┼×KENT UNIVERSITY PEDIATRIC NEPHROLOGY
 
Introduction:

 Successful renal transplantation allows a most near-normal life. In this study, we evaluated the effect of acute rejection on graft survival in our pediatric renal transplant patients.

Material and methods:

 We retrospectively evaluated data from 148 pediatric renal transplant patients over the last past 6 years. Demographics of the patients, cause of chronic renal failure, donor type, laboratory values, acute rejection episodes and graft survival were recorded.

Results:

 The mean age of patients was 15.91±4.66 years. 117 patients received a living-related donor allograft and the remaining 31 patients received the allograft from a deceased donor. Mean follow-up time after transplantation was 4.28±1.20 years. Biopsy confirmed acute rejection episodes were detected in 37 patients. 14 of them developed in the first six months after transplantation. 23 acute rejection episodes were seen after 6 months of transplantation. 17 patients had lost their graft during follow-up. Graft loss was found to be significantly higher in late acute rejection group (8/23), only one patient lost his graft in early acute rejection group (p<0.05). Remaining 8 patients had not acute rejection and they had loss their graft related to primary disease recurrence, chronic allograft nephropathy, de novo glomerulopathy or polyomavirus infection. Five year graft survival was significantly lower in late acute rejection group compared to early acute rejection and non rejection group (74%, 86%, 91%, respectively). De novo anti-HLA antibody, antibody mediated acute rejection and non adherence significantly higher in patients with late acute rejection (p<0.05).

Conclusions:

 Acute rejection is still an important risk factor for pediatric renal transplant patients. Especially late acute rejection had worse prognosis and inferior graft function for late acute rejection.  Close monitoring, early diagnosis and treatment of patients may improve graft function.