title: Patterns of Early Rejection in Renal Retransplantation: A Single-Center Experience.
abstract: It has been reported that kidney retransplant patients had high rates of early acute rejection due to previous sensitization. In addition to the acute antibody-mediated rejection (ABMR) that has received widespread attention, the early acute T-cell-mediated rejection (TCMR) may be another important issue in renal retransplantation. In the current single-center retrospective study, we included 33 retransplant patients and 90 first transplant patients with similar protocols of induction and maintenance therapy. Analysis focused particularly on the incidence and patterns of early acute rejection episodes, as well as one-year graft and patient survival. Excellent short-term clinical outcomes were obtained in both groups, with one-year graft and patient survival rates of 93.9%/100% in the retransplant group and 92.2%/95.6% in the first transplant group. Impressively, with our strict immunological selection and desensitization criteria, the retransplant patients had a very low incidence of early acute ABMR (6.1%), which was similar to that in the first transplant patients (4.4%). However, a much higher rate of early acute TCMR was observed in the retransplant group than in the first transplant group (30.3% versus 5.6%,P< 0.001). Acute TCMR that develops early after retransplantation should be monitored in order to obtain better transplant outcomes.
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China; Key Laboratory of Organ Transplantation, Ministry of Public Health, Wuhan, China.
authors.forename: Lan
authors.identifier: 0000-0003-4752-4939
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Fu
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Kailin
authors.initials: K
authors.lastname: Lin
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China; Key Laboratory of Organ Transplantation, Ministry of Public Health, Wuhan, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Guo
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China; Key Laboratory of Organ Transplantation, Ministry of Public Health, Wuhan, China.
authors.forename: Song
authors.initials: S
authors.lastname: Chen
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China; Key Laboratory of Organ Transplantation, Ministry of Public Health, Wuhan, China.
authors.forename: Zhengbin
authors.initials: Z
authors.lastname: Lin
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China; Key Laboratory of Organ Transplantation, Ministry of Public Health, Wuhan, China.
authors.forename: Zhishui
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China; Key Laboratory of Organ Transplantation, Ministry of Public Health, Wuhan, China.
authors.forename: Gang
authors.identifier: 0000-0003-0574-9785
authors.initials: G
authors.lastname: Chen
mesh_terms: D000328:Adult; D000906:Antibodies / Q000276:immunology*; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D006085:Graft Survival; D006801:Humans; D007114:Immunization; D007668:Kidney / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000276:immunology*
chemical_list: D000906:Antibodies