Age‐specific risk of renal graft loss from late acute rejection or non‐compliance in the adolescent and young adult period

Aims The aims of this study were to identify if an age‐specific high‐risk window for graft loss is present in Australia and New Zealand and identify the aetiology for such graft loss using the Australia and New Zealand Dialysis and Transplant Registry. Methods Retrospective cohort analysis of all renal transplants were performed in Australia and New Zealand during 1985–2010 in which the graft survived >3 months and the patient spent at least some time aged 10–30 years inclusive while the graft was functioning. Adjusted hazard ratio (aHR) for graft loss according to age, sex, race, cause of end‐stage kidney disease, transition, era of transplantation, donor type and human leucocyte antigen mismatch were calculated using an extended Cox proportional hazards model for graft loss from any cause and graft loss from late acute rejection (LAR) or non‐compliance. Results A total of 3289 grafts in 3048 recipients were included. A total of 757 grafts failed including 110 (15 %) from LAR or non‐compliance. Age was strongly associated with graft loss from LAR or non‐compliance (p