PMID- 19414936
OWN - NLM
STAT- MEDLINE
DCOM- 20090707
LR  - 20131121
IS  - 1319-2442 (Print)
IS  - 1319-2442 (Linking)
VI  - 20
IP  - 3
DP  - 2009 May
TI  - Acute rejection episodes after kidney transplantation.
PG  - 370-4
AB  - Acute rejection episodes (AREs) are a major determinant of renal allograft 
      survival. The incorporation of new immunosuppressive agents explains, at least 
      partially, the improvement seen in the results of transplantation in recent 
      years. The objectives of this study are to analyze the incidence and severity of 
      AREs, their risk factors and their influence on graft and patient survival. We 
      retrospectively studied 280 kidney transplants performed in adults at the Charles 
      Nicolle Hospital, Tunis, between 1986 and 2004. The diagnosis of ARE was based on 
      clinical data and response to treatment. Allograft biopsies were performed in ten 
      cases. The treatment of AREs consisted of pulse methylprednisolone and 
      anti-thymocyte globulin. There were 186 males (66.4%) and 94 females (33.6%), and 
      their mean age was 31 +/- 8.9 years. Overall, the 280 study patients experienced 
      a total of 113 AREs. Of them, 85 had only one ARE, 28 had two to three and none 
      had more than three AREs. A total of 68 AREs were completely re-versible, 42 were 
      partially reversible while three could not be reversed with treatment. The mean 
      inci-dence of AREs was 40.4%. The incidence was > 45% between 1986 and 1997, 
      decreased to 20.5% between 1998 and 2000 and to 9% between 2001 and 2004. Graft 
      survival rates in patients with and without AREs were respectively 91% and 93% at 
      three years, 82% and 90% at five years and 73% and 83% at 10 years. We found a 
      decrease in the incidence of AREs in recent years in our study patients, and this 
      was related to the introduction of sensitized cross-match and the newer 
      immunosuppressive agents, particularly MMF. Additionally, AREs had a deleterious 
      impact on late graft survival in our study population.
FAU - Hamida, Fethi Ben
AU  - Hamida FB
AD  - Department of Nephrology, Charles Nicolle Hospital, Tunis, Tunisia. 
      fethi.hamida@rns.tn
FAU - Barbouch, Samia
AU  - Barbouch S
FAU - Bardi, Rafika
AU  - Bardi R
FAU - Helal, Imed
AU  - Helal I
FAU - Kaaroud, Hayet
AU  - Kaaroud H
FAU - Fatma, Lilia Ben
AU  - Fatma LB
FAU - Hedri, Hafedh
AU  - Hedri H
FAU - Abderrahim, Ezzeddine
AU  - Abderrahim E
FAU - Abdallah, Taieb Ben
AU  - Abdallah TB
FAU - Ayed, Khaled
AU  - Ayed K
FAU - Maiz, Hedi Ben
AU  - Maiz HB
FAU - Kheder, Adel
AU  - Kheder A
LA  - eng
PT  - Journal Article
PL  - Saudi Arabia
TA  - Saudi J Kidney Dis Transpl
JT  - Saudi journal of kidney diseases and transplantation : an official publication of 
      the Saudi Center for Organ Transplantation, Saudi Arabia
JID - 9436968
RN  - 0 (Antilymphocyte Serum)
RN  - 0 (Immunosuppressive Agents)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Antilymphocyte Serum/therapeutic use
MH  - Female
MH  - Graft Rejection/*etiology/mortality/prevention & control/therapy
MH  - *Graft Survival/drug effects
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Incidence
MH  - Kidney Transplantation/*adverse effects/mortality
MH  - Male
MH  - Methylprednisolone/therapeutic use
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Survival Analysis
MH  - Time Factors
MH  - Treatment Outcome
MH  - Tunisia/epidemiology
MH  - Young Adult
EDAT- 2009/05/06 09:00
MHDA- 2009/07/08 09:00
CRDT- 2009/05/06 09:00
PHST- 2009/05/06 09:00 [entrez]
PHST- 2009/05/06 09:00 [pubmed]
PHST- 2009/07/08 09:00 [medline]
AID - SaudiJKidneyDisTranspl_2009_20_3_370_50758 [pii]
PST - ppublish
SO  - Saudi J Kidney Dis Transpl. 2009 May;20(3):370-4.