MULTIVARIATE-ANALYSIS OF RENAL LESIONS IN ACUTE GRAFT-REJECTION - PROGNOSTIC-SIGNIFICANCE AND DEFINITION OF A REJECTION SEVERITY SCORE

Although the value of graft biopsy in the management of acute renal graft rejection has long been established, there is an increasing need for standard criteria for assessing graft prognosis to maximize the clinical usefulness of information. In this study histological lesions observed in graft biopsies from 68 patients with acute rejection were analyzed by multivariate analysis to investigate their prognostic significance more deeply and to set up a simple and reproducible method of evaluating the risk of graft failure. The extent of endoarteritis and interstitial hemorrhage were the main factors in rejection outcome. A score based only on these lesions and the risk coefficients derived from statistical analysis correlated closely with rejection outcome. Since this score is easy to derive from graft biopsy examination and readily reproducible, this method of assessing rejection severity may provide a more objective and standard evaluation of the prognostic significance of the histological picture, thus providing clearer information to clinicians involved in patient management and making the exchange of data easier between different centers.