Hurtado-Castillo Yumar Alfredo, Serrano-Ramírez Juana Alejandra, Juaréz-Sánchez José Oscar, Gaytán-Campos Itzy Maely
Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Nefrología. León, Guanajuato, México.
Rev Med Inst Mex Seguro Soc. 2025 May 2;63(3):e6636. doi: 10.5281/zenodo.15178468.
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.
To assess the therapeutic response in patients who received intravenous immunoglobulin, plasmapheresis, steroid and rituximab as treatment for antibody-mediated renal rejection.
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.
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.
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.
抗体介导的肾移植排斥反应是移植肾丢失的主要原因之一。治疗基于清除循环抗体、抑制残留抗体、减少其形成、使同种异体反应最小化以及终末补体激活。
评估接受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的肾排斥反应患者的治疗反应。
对肾脏病服务部门护理下的住院患者进行了一项应用前瞻性研究，这些患者根据班夫标准诊断为抗体介导的肾移植排斥反应。1年内纳入20例患者，对活检进行复查以对抗体介导的排斥反应类型进行分类，并评估治疗反应以证明在随访12个月时肾功能是否稳定或改善。
使用威尔科克森检验比较了注射时活检时的肌酐水平与接受治疗方案12个月后的肌酐水平。Z值为-1.8，p = 0.069。
在接受基于类固醇、血浆置换、免疫球蛋白和利妥昔单抗的抗体介导排斥反应治疗12个月后，移植肾功能的稳定或恢复方面没有差异。
