Naslov
Acute Anditody-Mediated Rejection of the Kidney Transplant

Autori
Sladoje-Martinović, Branka ; Orlić, Lidija ; Živčić-Ćosić, Stela ; Rački, Sanjin ; Vuksanović-Mikuličić, Sretenka ; Maleta, Ivica ; Bubić, Ivan ; Pavletić-Peršić, Martina

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Transplantation / Suthanthiran Manikkam - New York (NY) : Lippincott Williams and Wilkins, 2012

Skup
24th International Congress of the Transplantation Society

Mjesto i datum
Berlin, Njemačka, 15.07.2012. - 19.07.2012

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
kidney transplantation; antibody-mediated rejection; intravenous immunoglobulin
(kidney transplantation; antibody-mediated rejection; intravenous immunoglobulins)

Sažetak
Introduction: Acute humoral rejection occurs in 20% of renal transplant patients. Its prognosis is worse than when it comes to cellular rejection, and it is refractory to conventional immunosuppressive therapy. C4d deposition in peritubular capillaries of the kidney transplant has shown as a sensitive diagnostic marker of acute antibody mediated rejection, which correlates with the presence of circulating donor specific antibodies. Aim of this work was to demonstrate our experiences with therapy and medical treatment results of kidney transplant patients with antibody mediated acute rejection. Patients and methods: Eight kidney transplant patients in whom the acute humoral rejection appeared have been analyzed, out of which four men and four women. The rejection has been proven by biopsy of the kidney transplant and/or the existence of donor specific antibodies. The average age of the patients was 39±14.3 years. The average duration of hemodialysis treatment was 5.9±5 years. In four patients the primary renal disease was glomerulonephritis, pyelonephritis in two, and endemic nephropathy, as well as nephronophtisis in one patient. All patients were subjected to cadaveric kidney transplantation. Three of them had already been transplanted before. In three patients humoral rejection appeared in a month after the operation (4-18 days), and in other five patients in 1-12 years. Results: Two patients were treated with plasmapheresis and intravenous immunoglobulin dose of 2 g per kg of body weight together in addition to the other means of immunosuppressive therapy. The other six patients were treated only with 2 g per kg of intravenous immunoglobulin together with the other means of immunosuppressive therapy. In seven patients the function of the kidney transplant recovered after the therapy, while in one patient recovery did not occur. Therefore the remaining patient has been subjected to hemodialysis treatment. The average values of serum creatinine (in seven patients) a month after the therapy ranged from 73 µmol/l to 279 µmol/l. In three patients in which the crises appeared during the first month, a complete recovery of kidney transplant function occured. In six months all of the seven patients had stable transplant function. Conclusion: From the above results, a conclusion can be drawn that the acute humoral rejection can be treated efficiently in case it is diagnosed on time and treated adequately.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti

POVEZANOST RADA