الفهرس 
Renal transplantationOnly 14 pages are availabe for public view
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Abstract
This study was conducted at National Institute Of Urology &
Nephrology aiming to study the impact of early and late acute rejection on
graft survival after renal transplantation.
We included a total of 120 cases with renal transplant, who were
divided into 3 groups; group I included 100 cases who did not experience
rejection, group II included 11 cases who developed early acute rejection,
and group III included 9 cases who developed late acute rejection.
There was no significant difference between the three groups
regarding age (29.8, 31.64, and 29.33 years respectively – p = 0.375).
Although the age was younger in late acute rejection group, it was not
significantly different between the study groups. Furthermore, there was
no significant difference between donor age in the three study groups (p =
0.838).
There was no significant difference between the three groups
regarding either recipient or donor gender (p = 0.932 and 0.567
respectively). Besides, there was no significant difference between the
three groups regarding donor-recipient relationship (p = 0.523). Either
having related or unrelated donor did not have an impact on acute rejection
in the current study.
The etiology of CKD or ESRD did not differ significantly between
the current study groups (p > 0.05). This may point to that the initial cause
of renal failure did not have an impact on development of acute rejection
in the current study. Likewise, the duration of dialysis did not constitute a
significant difference between the three study groups (p = 0.680).
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Summary
The duration of renal transplantation was not significantly different
between the three groups (p = 0.317). Although basal serum creatinine did
not differ between the three groups in the current study (p = 0.24), the last
follow up serum creatinine was significantly higher in both early and late
acute rejection groups (p < 0.001).
Poor drug compliance was more significantly encountered in the
early rejection group (27.3%), while it was not reported in the late
rejection. The non-rejection group reported non-compliance in 2% of its
cases (p = 0.009).
HLA mismatch was also statistically significant between the three
study groups (p = 0.027). It was present in 11.1% and 9.1% of cases in
LAR and EAR groups respectively. Nevertheless, it was absent in the nonrejection
group. On the other hand, old donor age was significantly more
prevalent in the early rejection group (p = 0.013).
CMV infection had significantly higher prevalence in the rejection
groups (18.2 and 22.2% respectively), while it was present in only 2% in
the non-rejection group (p = 0.007).
The current results showed that there was significant difference
between the three study groups regarding the GFR at the end of the study
duration (p < 0.05). GFR was markedly decreased in both early and late
rejection groups (19.73 and 20.33) compared to non-rejection group (GFR
= 73.08).
The incidence of ESKD was significantly higher in the rejection
groups compared to the first group (p = 0.012). Therefore, it is evident that
acute rejection has a negative impact on graft survival. Nevertheless, the
incidence of CKD was higher in the group I (67%) compared to the
rejection groups (63.6 and 66.7% respectively). Mortality did not constitute