Table 3.
Causes of late graft failure: a summary of recent studies.
| Study | Causes of graft failure | n (%) |
|---|---|---|
| El-Zoghby et al. [16] n = 1317 | Total graft failures | 153 (12) |
| Acute rejection | 18 (12) | |
| Glomerular disease | 56 (37) | |
| Medical/surgical | 25 (16) | |
| Unknown cause | 7 (5) | |
| Fibrosis/atrophy (IF/TA) | 47 (31) | |
| Causes of fibrosis/atrophy | ||
| Polyoma virus nephropathy | 11 (23) | |
| Immunologic (recurrent rejections) | 13 (28) | |
| Recurrent pyelonephritis | 7 (15) | |
| Poor allograft quality | 4 (9) | |
| Ureteral stenosis | 2 (4) | |
| Calcineurin inhibitor toxicity | 1 (2) | |
| Idiopathic | 9 (19) | |
| Gourishankar et al. [17] n = 2427 | Total graft failures | 48 |
| Rejection | (38) | |
| Thrombosis | (17) | |
| Viral nephropathy | (10) | |
| Others | (35) | |
| Einecke et al. [18] n = 173 | Total graft failures | 27* |
| Banff classification | ||
| C4d+ antibody-mediated rejection | 7 (26) | |
| T-cell-mediated rejection† | 6 (22) | |
| Glomerulonephritis | 6 (22) | |
| IF/TA | 1 (4) | |
| Others | 7 (26) | |
| Modified antibody-mediated-rejection definition‡ | ||
| C4d+ antibody-mediated rejection | 7 (27) | |
| C4d− antibody-mediated rejection (PRA+ with microcirculation changes) | 10 (38) | |
| Panel-reactive antibody positive without microcirculation changes | 1 (4) | |
| Panel-reactive antibody negative | 2 (8) | |
| Glomerulonephritis | 6 (23) | |
| Sellarés et al. [19] n = 315 | Total graft failures | 60 |
| Acute rejection§ | 36 (64)¶ | |
| Glomerulonephritis | 10 (18) | |
| Polyoma virus nephropathy | 4 (7) | |
| Intercurrent medical/surgical events | 6 (11) | |
| Missing information | 4 (7) | |
*
Late graft failures (>12 months after transplantation) only.
†
T-cell-mediated rejection or borderline T-cell-mediated rejection.
‡
n = 26 (PRA data not available for one patient).
§
Data include antibody-mediated rejection, probable antibody-mediated rejection and mixed rejection.
¶
Percentage based on n = 56 (causality could not be attributed in four cases because of missing clinical information).