Abstract:

Pretransplant risk assessment is an important basis for individual use of immunosuppressive agents.The accuracy of immunological risk assessment include many factors.For donors,deceased donation and older donor age remains a significant predictor.For recipientrelated risk factors for acute rejection,the most compelling evidence points to younger age,African American ethnicity,nonadherence to medication,and female patients with more than one pregnancy.At the time of transplant,delayed graft function is one of the most clearcut risk factors for acute rejection.Extended cold ischemia time (≥24h) may also play a contributory role.Conventional immunological markers,eg human leukocyte antigen (HLA), mismatching,complementdependent cytotoxic (CDC)  testing and pretransplant antiHLA alloantibodies) are being reassessed.Together,these offer a realistic basis for planning an appropriate immunosuppression regimen in individual patients.