Objective: To identify the risk factors of acute rejection events after living related donor renal transplant.
Methods: Renal transplantation was performed on 117 patients, 85 males and 32 females, aged 9-57, with the kidneys from 117 donors, 63 males and 54 females, aged (47 +/- 6) (20-65). The cumulative incidence of acute rejection events was respectively evaluated by Kaplan-Meier product-limit method and log-rank test. Cox's proportional hazards model was used to determine the risk factors for acute rejection events.
Results: Follow-up was conducted for 16 (3-44) months. The acute rejection rates 2 and 6 weeks after transplantation of the group with the donor aged > or = 50 were 13.0% and 19.5% respectively, both significantly higher than those of the group with the donor aged < 50 (2.8% and 8.5% respectively, P = 0.010). The risk of being female for acute rejection was 2.731 times as that of being male (95% CI: 1.018-7.326, P = 0.046), and the risk of donor aged > or = 50 for acute rejection was 1.054 times as that of the donors aged < 50 (95% CI: 1.004-1.107, P = 0.020).
Conclusion: The requirement for selecting elder living kidney donor should be stiff. Injury to the kidney should be avoided when the kidney of an elder donor is removed and transplanted. Early administration of sufficient immunosuppressive agents is necessary to the recipients of the kidney from an old or female living donor.