Principal cause of death in renal transplant patient
Uraemia
Malignancy
Rejection
Infection
Ref cambell's urology,8/e p346-349 * The graft rejection response is initiated mainly by host T cells that recognize the foreign HLA antigens of the graft, either directly (on APCs in the graft) or indirectly (after uptake and presentation by host APCs). * Types and mechanisms of rejection comprise the following: Hyperacute rejection: Pre-formed antidonor antibodies bind to graft endothelium immediately after transplanta- tion, leading to thrombosis, ischemic damage, and rapid graft failure. Acute cellular rejection: T cells destroy graft parenchyma (and vessels) by cytotoxicity and inflammatory reactions. Acute humoral rejection: Antibodies damage graft vasculature. Chronic rejection: Dominated by aeriosclerosis, this type is probably caused by T cell reaction and secretion of cytokines that induce proliferation of vascular smooth muscle cells, associated with parenchymal fibrosis. Principal cause of death is due to infection and inflammation
General anatomy