Introduction: Studies suggested seasonal variation in Immune response. During winter, stronger pro-inflammatory state and higher autoimmune diseases incidence is observed. This variation might affect transplant immunology. This study to report effect of seasonal variation on rejection Methods: A retrospective review included all kidney transplants at Sheffield Kidney unit from 2008 to 2012. Patients follow-up was 46±25 months (Mean ± SD). Date collected including Age of donor and recipient, Donor type, First or previous transplant, HLA match, Immunosuppression (Induction & maintenance), Graft Follow Up in Months& Graft Failure. Biopsy proven rejection was analysed (type of rejection, Treatment, Recurrence, rejection season). December, January and February were considered Winter. Biopsies after 90 days of initial rejection were considered as recurrence. SPSS 20 was used for statistical analysis Results: 435 transplants were included and 43 grafts (10%) suffered rejection. 79 biopsy proved rejection episodes were classified according to season of rejection (Winter/Non Winter). No difference between both groups except all winter rejections had triple maintenance immunosuppression as in table. More rejection episodes in Winter required more than steroid pulse to treat in comparison to rejection at the rest of the year (60% vs 45%, p 0.03, Chi2) suggesting more aggressive immune response. Discussion: Reports suggested more aggressive immune response in general during winter. Winter rejections were difficult to treat even they had more immunosuppression. This is the first clinical observation to report a seasonal variation in organ rejection.
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