Abstract
Multiple factors influence graft rejection after kidney transplantation. Pre-operative factors affecting graft function and survival include donor and recipient characteristics such as age, gender, race, and immunologic compatibility. In addition, several peri- and post-operative parameters affect graft function and rejection, such as cold and warm ischemia times, and post-operative immunosuppressive treatment. Exposure to non-self-human leucocyte antigens (HLAs) prior to transplantation up-regulates the recipient’s immune system. A higher rate of acute rejection is observed in transplant recipients with a history of pregnancies or significant exposure to blood products because these patients have higher panel reactive antibody (PRA) levels. Identifying these risk factors will help physicians to reduce the risk of allograft rejection, thereby promoting graft survival. In the current review, we summarize the existing literature on donor- and recipient-related risk factors of graft rejection and graft loss following kidney transplantation.
Highlights
Received: 12 January 2022Kidney transplantation (KTx) is the treatment of choice for end-stage renal diseases (ESRD) [1]
human leucocyte antigens (HLAs)-A and -B matching was associated with an 8% increase in one-year lung transplantation survival rate, HLA-DR matching with a 10% increase, and HLA-B + DR matching with a 19% increase [40]
Graft rejection and graft loss after KTx depend on multiple factors
Summary
Hani Oweira 1 , Ali Ramouz 2 , Omid Ghamarnejad 2 , Elias Khajeh 2 , Sadeq Ali-Hasan-Al-Saegh 2 , Rajan Nikbakhsh 2 , Christoph Reißfelder 1 , Nuh Rahbari 1 , Arianeb Mehrabi 2, * and Mahmoud Sadeghi 3.
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