Role of various markers in rejection and survival of renal transplant

Long term survival of renal graft is still a challenge in this era of better immunosuppression.This study highlighted the role of immunological & biochemical markers involved in transplant rejection.Cell mediated immunity is the main cause of rejection in both ACR and CAN while in CAN humoral immunity is also involved along with cellular immunity. Study supports that histopathology is still a gold standard test for differentiation of rejection.SCr is still a cheap & sensitive serological marker to diagnose rejection & is equally good as β2m.Blood cholesterol should be kept on lower side.Screening for infections such as TB,CMV & S.paratyphi should be carried out for long term survival.HLA plays crucial role in survival. Study supported that HLA A33 has protective role while HLA A23,B37,DR1,DR3,DR8,DR53 have predisposing effect for renal failure in transplant recipient.Graft survival is better for 2 HLA antigens mismatch between donor and recipient than only 5/4/3 HLA antigen mismatch between donor & recipient.Study also throws light that male donor & male recipient have better graft survival than female recipient or male recipient with female donor.