Renal Graft Rejection
After effective functioning for several years transplanted kidney suddenly ceases to function resulting chronic rejection.
Signs & Symptoms of Chronic Renal Graft Rejection
The signs and symptoms of chronic rejection include the following:
- Hardening of renal vessels (nephrosclerosis)
- Hardening proliferating up to Vascular intima (innermost layer) of renal vessels
- Marked decrease in lumen of the vessel
Results of Renal Graft Rejection
The symptoms often lead to following severe complications:
- Renal ischemia
- Tubular atrophy
- Interstitial fibrosis
- Nephrogenic systemic fibrosis (NSF)
- Glomerular atrophy
- Eventual renal failure
Causes for Renal Graft Rejection
The following factors usually contribute to renal graft rejection:
- HLA incompatibility
- Number of nephrons
- Ischemic history of a donor kidney
The causes of renal graft vary with the time (usually classified as immediate, early, and late period) after transplantation. Depending on the time, different causes such as prerenal, post renal and intrinsic causes of failure are generally proposed.
Serum creatinine level:
During initial stages when renal function is sound increase in serum creatinine level is the most sensitive and reliable indicator of possible graft rejection
useful in ascertaining changes in the renal vasculature
sodium renograms of the transplanted kidney helpful in evaluating the renal blood flow, even in the absence of urinary flow.
Calcineurin inhibitors (cyclosporine or tacrolimus) may cause slow deterioration in renal function that is very similar to graft rejection. Renal biopsy is the only method recommend to diagnose this.