Should the First Rejected Kidney Implant be Removed?

Abstract

Renal transplantation (TX) is widely used as a definitive therapy for chronic, end-stage organ failure. T cells are pivotal in rejection (RX), and RX is a process whereby donor tissue is recognized and destroyed by the host immune system. Within a rejecting graft it is likely that high concentrations of IL-2 are present. The binding of interleukin 2(IL-2) to its receptor (IL-2R) on human T cells constitutes the key regulatory event in the initiation and maintenance of the immune response. The receptor, IL-2R, is found in two forms: cellular and soluble. The surgical removal of a transplanted kidney following RX or failure can be hazardous. Two surgical techniques were applied: extracapsular and intracapsular removal. The technique of kidney transplant removal by either the intra- or extra-capsular route of the exact timing of the operation are important features for safe treatment of patients with end-stage graft failure. The results of the report are a prospective study on 21 renal TX recipients, and show that nephrectomy of previous TX kidney will reduce the levels of four markers in serum and urine.