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Causes of Early Kidney Allograft Nonfunction

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Solid Organ Transplantation in Infants and Children

Part of the book series: Organ and Tissue Transplantation ((OTT))

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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.

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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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Author information

Authors and Affiliations

  1. (HNP3) Division of Extramural Research, (NIDCR) National Institute of Dental and Craniofacial Research, BG 1DEM RM 638, 6701 Democracy Blvd, Bethesda, MD, 20817, USA

    Kevin D. McBryde

  2. Division of Solid Organ Transplantation, Emeritus, Alfred I. duPont Hospital for Children, 1600 Rockland Rd, Wilmington, DE, 19803, USA

    Bruce A. Kaiser

Authors
  1. Kevin D. McBryde
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  2. Bruce A. Kaiser
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Corresponding author

Correspondence to Kevin D. McBryde .

Editor information

Editors and Affiliations

  1. Department of Surgery, Jefferson Medical College, Wilmington, Delaware, USA

    Stephen P. Dunn

  2. Division of Gastroenterology, Seattle Children’s Hospital, Seattle, Washington, USA

    Simon Horslen

Section Editor information

  1. Division of Solid Organ Transplantation, Emeritus, Alfred I. duPont Hospital for Children, Wilmington, DE, USA

    Bruce Kaiser

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McBryde, K.D., Kaiser, B.A. (2018). Causes of Early Kidney Allograft Nonfunction. In: Dunn, S., Horslen, S. (eds) Solid Organ Transplantation in Infants and Children. Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-07284-5_33

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  • DOI: https://doi.org/10.1007/978-3-319-07284-5_33

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-07283-8

  • Online ISBN: 978-3-319-07284-5

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