Age's risk factor for acute renal transplant rejection

Q: Which of the following is at increased risk of acute kidney rejection post-transplant? - select one

A) older recipient and young donor

B) Younger recipient and older donor 

Answer: B

The following are the major risk factors for high immunologic risk of acute rejection.

• One or more human leukocyte antigen (HLA) mismatches
• Younger recipient and older donor age
• Presence of a donor-specific antibody (DSA)
• Blood group incompatibility
• Delayed onset of graft function
• Cold ischemia time greater than 24 hours
• Previous episode of rejection
• Receipt of a second or greater transplant
• Medication nonadherence

Younger patients' innate strong immunity may react vehemently to an older donor's organ.

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#nephrology

References:

1. Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant 2009; 9 Suppl 3:S1.