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Complications

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Conditions associated with transplantation and immunosuppression:

  • acute and chronic rejection
    • acute rejection - this occurs 3-6 months after transplantation; features include rising serum creatinine (also occasionally graft pain and fever); graft biopsy reveals tubular damage and an immune cell infiltrate; treatment options include high-dose corticosteroids
    • chronic rejection - occurs >6 months after transplantation; gradual increase in serum creatinine and proteinuria. Graft biopsy reveals fibrosis, vascular changes and tubular atrophy. Chronic rejection is not responsive to increased immunosuppression
  • acute tubular necrosis
  • thrombosis
  • opportunistic infections
  • hypertension - occurs in more than 50% of transplant patients; causes include diseased native kidneys, graft dysfunction or immunosuppressant drugs
  • cyclosporin toxicity
  • increased risk of malignancy - particularly, lymphoproliferative disorders such as non-Hodgkin's lymphoma and squamous-cell skin carcinoma

Conditions that can recur in the transplanted kidney:

  • mesangiocapillary glomerulonephritis
  • focal segmental sclerosis
  • IgA nephropathy
  • Goodpasture's syndrome
  • vasculitides

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