Causes of Early Kidney Allograft Nonfunction

Reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)

Abstract

Early allograft non-function can be divided into immediate posttransplant period (days 0–7) and early posttransplant period (weeks 1–12). Immediate non-function is most commonly related to delayed graft function and is usually seen in deceased donor kidneys with longer cold ischemic time. Also, during this first week, surgical complications are more common and can include both vascular thrombosis and urologic obstruction. After that first week, during the early period, there is a greater variety of etiologies for non-function that include acute rejection, recurrence of primary disease, drug toxicity, and urological leaks. Delayed graft function can extend beyond the first week, and in this scenario, an allograft biopsy should be done since acute rejection is hard to diagnose in this situation. During these early periods, kidney non-function is more commonly associated with delayed graft function because in the current era of more aggressive immunosuppression protocols, the incidence of acute rejection is low.

Keywords

Acute rejection Allograft non-function Children Cold ischemia time Congenital urinary tract abnormalities Delayed graft function End-stage renal disease Hyperacute rejection Kidney transplantation Recurrent disease Vascular thrombosis Urinary obstruction 

Abbreviations

ATN

Acute tubular necrosis

BKV

BK virus

CAKUT

Congenital anomalies of the kidneys and urinary tract

CMV

Cytomegalovirus

CNIs

Calcineurin inhibitors

DFG

Delayed graft function

ESRD

End-stage renal disease

FSGS

Focal segmental glomerulosclerosis

HLA

Human leukocyte antigen

HUS

Hemolytic uremic syndrome

PCR

Polymerase chain reaction

UTI

Urinary tract infection

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.(HNP3) Division of Extramural Research(NIDCR) National Institute of Dental and Craniofacial ResearchBethesdaUSA
  2. 2.Division of Solid Organ Transplantation, EmeritusAlfred I. duPont Hospital for ChildrenWilmingtonUSA

Section editors and affiliations

  • Bruce Kaiser
    • 1
  1. 1.Division of Solid Organ Transplantation, EmeritusAlfred I. duPont Hospital for ChildrenWilmingtonUSA

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