Impact of Acute Rejection on Long-Term Patient Survival and Graft Outcome in Kidney Transplant Recipients at a Tertiary Care Center in South India (Code-T0149)

Introduction: Acute rejection (AR) is a significant complication in kidney transplant recipients and is associated with impaired graft function and long-term survival outcomes. The impact of AR on these outcomes varies depending on the severity, timing, and management of rejection episodes. Understanding these relationships is crucial for improving patient and graft survival in kidney transplantation.

Aims and Objectives: This study aims to evaluate the impact of acute rejection episodes on long-term patient survival and graft function in kidney transplant recipients at a tertiary care center in South India.

Methods: A retrospective cohort study was conducted on kidney transplant recipients who underwent transplantation between 2010 and 2020. Data on AR episodes, patient survival, graft function, and immunosuppressive therapy were collected and analyzed. AR was diagnosed based on clinical, laboratory, and histopathological findings. The outcomes, including patient survival rates and graft failure, were assessed over a follow-up period of five years. Statistical analysis was performed to identify associations between AR episodes and long-term outcomes.

Results: Among 250 transplant recipients, 45 experienced at least one episode of acute rejection. The study found that AR significantly affected long-term graft survival, with a higher incidence of graft loss and reduced graft function in patients who experienced AR. However, the survival rate of patients who experienced early or mild AR was comparable to those without rejection. Severe or late AR episodes correlated with a significantly higher risk of graft failure and decreased patient survival (p < 0.05).

Conclusion: Acute rejection has a detrimental impact on long-term graft outcomes, particularly in severe or late cases. Early detection and management of AR are essential for improving both patient survival and graft function.

Keywords: Acute rejection, Kidney transplant, Graft survival, Patient survival, Immunosuppression, South India.