Impact of subclinical acute rejection on renal graft function: Results of three-year follow-up

Notwithstanding that in the last years the immediate results of kidney transplantation have been improved, there has been no adequate improvement of long-term results. Therefore, more attention is being paid to the so-called subclinical rejections of renal grafts, detected by protocol biopsies, as a possible factor affecting renal function in late period. The aim of this study was to determine the frequency of subclinical rejections and their impact on further renal graft function. Within the frame of the study 40 protocol biopsies were performed in 26 patients with immediate and stable renal graft function. In 17 (65.4%) of them a subclinical rejection of IA-IIA degree was detected. In nine patients with subclinical rejection, treatment with steroids was applied, while eight recipients did not receive any additional therapy. In follow-up, in a period of three years there was no statistically significant difference in blood creatinine level, glomerular filtration rate, number of clinical rejections during the monitoring period, and three-year survival of the transplanted kidney in patients, regardless of where the treatment of subclinical rejection was applied. The results of our study did not indicate any impact of subclinical rejection on renal graft function in the late post-operation period.