Renal Transplantation – Mechanisms and Management of Early Rejection

Acute graft rejection remains the strongest risk factor for the development of chronic allograft nephropathy and ultimately graft loss. Hyperacute rejection is now rarely encountered with excellent pre-transplant evaluation. The mechanism of accelerated and acute rejection are now better understood. Besides using IV methylprednisolone, OKT3 polyclonals, tacrolimus, MMF, plasmapheresis, antilymphocyte antibody, highdose IgG and rituximab are being successfully employed in the management.