Saber UCV
Repositorio Institucional
Repositorio Institucional
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https://saber.ucv.ve/handle/10872/8051
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| Title: | Rechazo Humoral agudo demostrado por biopsia en pacientes transplantados renales |
| Authors: | Morales Lucena., Ruth Dilmar |
| Keywords: | Rechazo humoral agudo, terapéutica, biopsia. Acute humoral rejection, therapeutics, biopsy. |
| Issue Date: | 13-Jan-2015 |
| Abstract: | Objetivo: Determinar la Frecuencia de Rechazo Humoral Agudo (RHA), en pacientes trasplantados renales atendidos en el Servicio de Nefrología, del Hospital Dr. “Miguel Pérez Carreño” durante el periodo enero 2007- diciembre 2010. Métodos: Investigación descriptiva retrospectiva. Se incluyeron todos los trasplantados renales con RHA, demostrado por biopsia. Resultados: De 262 trasplantados, 19 (7%) presentaron RHA. Predomino en el sexo femenino con 58% y en jóvenes 20-40años (53%). Del total (19) un 58% tenían un PRA mayor a 10%, y tenían factores previos de sensibilización. El factor de sensibilización que predominó fueron las transfusiones (47%). Un 58% recibió un injerto de cadáver. El 79%de los pacientes tenían más de 1 año en diálisis. La isquemia fría fue mayor de 12 horas en un 58%. Se presento disfunción aguda del injerto en un 58% y un 42% función retardada del injerto. En ocho pacientes (42%), se presento antes de la dos semanas, en 6 (32%) entre la segunda y la venticuatro semana del trasplante y 5(26%) luego de la semana veinticinco. Histológicamente 17 (89,47%) fueron rechazos mixtos, todos C4d positivos. Los hallazgos que predominaron: injuria tubular aguda y tubulitis (89,5%); neutròfilos en capilares peritubulares y glomerulares (68,4%). El 52,63% (10) recibieron solo dos esquemas de tratamiento. La totalidad de pacientes tratados presentaron mejoría de la creatinina. Conclusiones: Nuestra frecuencia es comparable con la literatura mundial. La sobrevida del injerto y del paciente fue del 100% al año. |
| Description: | To determine the frequency of acute humoral rejection (AHR) in patients with kidney transplants performed at the Nephrology Department of Dr. Miguel Perez Carreño Hospital, from January 2007 to December 2010. Methods: A retrospective descriptive study. All patients with kidney transplants featuring biopsy-confirmed AHR were included. Results: from 262 transplants, 19 (7%) had RHA. Predominance of female (58%) and young patients (20-40 y/o) was shown. From these patients (19), 58% had PRA over 10%, and had previous sensitization factors. Predominant sensitization factor was blood transfusions (47%). Fifty-eight percent received cadaveric grafts. Seventy-nine percent of the patients had been dialyzed for over 1 year. Cold ischemia was over 12 hours in 58% of the patients. Acute graft dysfunction was present in 58% and 42% had delayed graft function. In eight patients (42%), it appeared before two weeks, in 6 (32%) it did between 2nd and 24th week from transplantation and 5 (26%) after the 25th week. Histologically, 17 (89.47%) were mixed rejections, all of them were C4d+. Predominant findings were: acute tubular injury and tubulitis (89.5%); neutrophils in peritubular and glomerular capillaries (68.4%). Ten (52.63%) patients received only two treatment schedules. All treated patients showed improvement in creatinine values. Conclusions: Our frequency is comparable to most authors worldwide. Survival of both graft and patient was 100% after one year. |
| URI: | http://hdl.handle.net/10872/8051 |
| Appears in Collections: | Otras |
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