[抗体介导的肾移植排斥反应的治疗反应和监测]。

Yumar Alfredo Hurtado-Castillo, Juana Alejandra Serrano-Ramírez, José Oscar Juaréz-Sánchez, Itzy Maely Gaytán-Campos
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引用次数: 0

摘要

背景:抗体介导的肾移植排斥反应是肾移植损失的主要原因之一。治疗的基础是清除循环抗体,抑制残留抗体,减少其形成,最大限度地减少异体反应和末端补体激活。目的:评价静脉注射免疫球蛋白、血浆置换、类固醇和利妥昔单抗治疗抗体介导性肾排斥反应的疗效。材料和方法:一项适用的前瞻性研究在肾内科治疗的住院患者中进行,根据BANFF诊断为抗体介导的肾移植排斥反应。在1年内纳入了20例患者,对活检进行了回顾,以努力分类抗体介导的排斥反应类型,并评估了对治疗的反应,以证明在12个月的随访中肾功能是否稳定或改善。结果:采用Wilcoxon检验,比较注射组活检时的肌酐和治疗方案12个月后的肌酐。Z值为-1.8,p = 0.069。结论:在接受基于类固醇、血浆交换、免疫球蛋白和利妥昔单抗的抗体介导排斥治疗12个月后,移植肾功能的稳定或恢复没有差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Therapeutic response and monitoring of antibody-mediated renal graft rejection].

Background: Antibody-mediated renal graft rejection is one of the main causes of graft loss. Treatment is based on the removal of circulating antibodies, inhibition of residual antibodies, reduction of their formation, minimization of the alloresponse and terminal complement activation.

Objective: To assess the therapeutic response in patients who received intravenous immunoglobulin, plasmapheresis, steroid and rituximab as treatment for antibody-mediated renal rejection.

Material and methods: An applicative, prospective study was carried out in hospitalized patients under the care of a nephrology service with a diagnosis of antibody-mediated rejection of the renal graft according to BANFF. 20 patients were included in 1 year, the biopsy was reviewed in an effort to classify the type of antibody-mediated rejection and the response to treatment was evaluated to demonstrate whether there was stabilization or improvement in renal function at 12 months of follow-up.

Results: Using the Wilcoxon test, creatinine during the biopsy of the injected and creatinine 12 months after receiving the therapeutic regimen were compared. The Z value was -1.8, with a p = 0.069.

Conclusions: There was no difference in terms of stabilization or recovery of renal graft function after 12 months of receiving treatment for antibody-mediated rejection based on steroids, plasma exchanges, immunoglobulin and rituximab.

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