Early severe renal allograft rejection

T. V. Berne, L. A. Gustafsson and S. N. Chatterjee

An early, severe form of renal allograft rejection, occuring after an initial day or more of good function and within the first week after transplantation, is an increasingly recognized phenomenon. This type of rejection occurred in 17 of 187 (9%) postmortem-donor renal transplants. It could only be reversed in four grafts, and two of these failed because of recurrent rejection within four months. No clinical observations were helpful in determining which cases were likely to respond to antirejection therapy. Of the 17 patients, four died. Because of the poor graft survival and the high mortality, attempts to treat early severe rejection may not be warranted.