Graft endothelial lesions resulting from acute rejection may be sustained by concomitant
hypercholesterolemia, thus increasing the risk of chronic graft failure. The present study was undertaken to examine the influence of
hypercholesterolemia and acute graft rejection (AGR) episodes on graft function and graft loss due to chronic nephropathy. A cohort of 336 patients transplanted between 1993 and 2000 having graft function at 12 months after
transplantation were examined. Immunosuppressive therapy consisted of CsA,
azathioprine, and
corticosteroids in 90% with 10% of patients receiving
mycophenolate mofetil in place of
azathioprine. During the first year after
transplantation, AGR occurred in 134 (39.8%) and
hypercholesterolemia (6.2 mmol/L) in 132 (39.2%) of patients. The population was divided into four groups according to AGR occurrence and
cholesterol concentrations during the first year after
transplantation for analysis of serum
creatinine concentrations and graft loss at 5 years of follow-up. Patients with AGR irrespective of
cholesterol levels displayed significantly higher
creatinine concentrations. Graft loss in these patients increased over twofold compared to the remaining groups. Patients without
hypercholesterolemia and AGR showed normal
creatinine concentrations and low graft loss rates during 5 years of follow-up.