Early Versus Late Acute Renal Allograft Rejection

We studied the effect of acute renal allograft rejection and its timing on the development of chronic rejection and subsequent graft loss. Between January 1, 1987 and April 30, 1991, 424 patients at the University of Minnesota received a primary kidney transplant (minimum follow-up, 1 year). Patients were subdivided by donor source, presence or absence of acute rejection, and the timing of acute rejection onset (early, 60 days post-transplant). For living donor (LD) transplant recipients (n = 219), the incidence of chronic rejection is 0.8% in those who had no acute rejection (n = 130), 20% in those with acute rejection 60 days (n = 30) (P 60 days (n = 27) (P 1 acute rejection episode had significantly more chronic rejection than those with only 1 rejection (P 60 days (vs. < or = 60 days) have an increased incidence of chronic rejection.