A study has suggested that adverse health effects of air pollution may also lead to serious adverse clinical outcomes in patients with kidney transplants. Increased ambient fine particulate matter (PM2.5) concentration is related to an increased possibility of adverse posttransplant outcomes-acute rejection, graft failure, and death. PM_2.5 level is known to be an independent risk factor associated with poor outcomes in kidney transplant patients. 

An important highlight of this study is that increased PM_2.5 concentration was linked to increased risk of kidney graft failure, which is consistent with previous reports with similar findings. Kidney graft rejection is a significant risk factor associated with graft loss. An alloimmune etiology is suggested to be a possible pathway for rejection associated with an increased risk of graft loss.

It was also noted that with 10ug/m3 rise in PM_2.5 levels, a 215 increase in mortality risk among individuals with kidney transplant occurs. Hence, intensified efforts towards cleaner air are needed, which may reduce the burden of adverse outcomes following a kidney transplant. Furthermore, in clinical practice, if patients receiving kidney transplants live in areas with lower levels of PM_2.5 concentration, their transplant outcomes may be improved. 

Reference: 1. Chang SH, Merzkani M, Murad H, et al. Association of ambient fine particulate matter air pollution with kidney transplant outcomes. JAMA Netw Open. 2021; 4: e2122190.