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Why Transplanted Kidneys Attack Themselves
The complement system is emerging as a major determinant of kidney transplant injury, rejection, and recovery. Rather than acting only as a terminal lytic pathway, complement connects innate and adaptive immunity and contributes to ischemia/reperfusion injury, delayed graft function, T-cell activation, antibody-mediated rejection, and thrombotic microangiopathy.
The most clinically important perioperative risk factors for delayed graft function are DCD donation and recipient anuria. When both are present, DGF risk rises markedly—reported around 70% in one retrospective cohort—and older…
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