Risk Factors for Chronic Rejection

Several risk factors for the development of OB/BOS have been identified, that can be subdivided into immunological and nonimmunological risk factors. Late or recurrent/refractory acute rejection and lymphocytic bronchitis/bronchiolitis were the most convincing (16), which together with repeated Ai acute rejection, noncompliance, human leucocyte antigen (HLA) mismatches at the A locus and total HLA mismatches, constitute the immunological risk factors (17). 

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Almond PS, Matas A, Gillingham K, Dunn DL, Payne WD, Gores P, Gruessner R, Najarian JS. Risk factors for chronic rejection in renal allograft recipients.Transplantation 1993 55 752-756. 

Although acute rejection is rarely a cause of early mortality, it is the most important predictor of long-term survival (35). Most patients experience at least one episode of acrtte rejection during the first few weeks after transplant (7). Frequency and severity of rejection have been repeatedly identified as principal risk factors for chronic rejection or the development of bronchiolitis obliterans (36,37). 

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