Vnitr Lek 2007, 53(3):246-252

Acute humoral rejection of renal transplant

J. Slatinská^1,*, E. Honsová², L. Lyerová¹, A. Slavčev³, O. Viklický^1,*

¹ Klinika nefrologie, Transplantační centrum Institutu klinické a experimentální medicíny, Praha, přednosta prof. MUDr. Vladimír Teplan, DrSc.

² Oddělení klinické a transplantační patologie Institutu klinické a experimentální medicíny, Praha, přednostka prim. MUDr. Eva Honsová

³ Imunologické pracoviště Institutu klinické a experimentální medicíny, Praha, přednosta doc. MUDr. Ilja Stříž, CSc.

Acute humoral rejection (AHR) is a rare complication which often results in the loss of kidney graft. The objective of this retrospective monocentric study was to evaluate two different approaches to AHR. Documentation of 730 patients was analysed, who underwent renal transplantation between 2002 and 2005. From 2002 to 2003, patients with AHR were treated with 5 plasmaphereses (PF group, n = 13), and from 2004 to 2005 with a combination of 5 PF and intravenous immunoglobulins (PF + IVIG, 0.5 g/kg, n = 8). Data for the period of one year post-transplant was analysed. AHR occurred in 21 out of 730 patients (2.9 %). Survival of grafts in the 6th month and in the 1st year was significantly higher for the PF + IVIG group than for the PF group only (p < 0.05). Patient survival was similar in both groups. The incidence of infectious complications was similar in both groups. There was a higher incidence of acute cellular rejections in the PF group (46.2 vs. 14.3 %) in control rebiopsies (performed due to deteriorated graft function or in order to check the efficiency of the treatment). It can be concluded that acute humoral rejection of transplanted kidney is a rare complication which can be treated by the combination of plasmaphereses and intravenous immunoglobulins.

Keywords: kidney transplant; humoral rejection; treatment; plasmaferesis

Received: November 7, 2006; Accepted: January 9, 2007; Published: March 1, 2007  Show citation