A study of 62 renal allografts was made to determine which characteristics of acute rejection may allow early identification of those grafts with a very low probability of ultimate success. Graft survival was reduced to below 20% and patient survival to below 50% with the fourth acute rejection episode. Of those grafts which were unable to return the serum creatinine value to within 20% of the prerejection level, 93% ultimately failed and 47% of the patients died. These features of acute rejection offered the best guides to the ultimate outcome of the transplant and are useful in determining when to abandon a renal allograft rather than subject the patient to the risks of additional immunosuppression.
Silcott GR, Barbour BH, Mendez R, Bischel MD, Berne TV. Functional Recovery From Acute Rejection as a Guide to Ultimate Renal Graft Survival. Arch Surg. 1972;104(6):791-793. doi:10.1001/archsurg.1972.04180060041010