[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.