Kidney Comics: T-Cell Mediated Rejection (Kidney Transplant)
By: Dr. Momen Abbasi
By: Dr. Momen Abbasi
In renal transplant recipients with allograft dysfunction, differentiating between a viral infection or acute cellular rejection as the etiology of interstitial nephritis can be difficult – especially as they can commonly occur concurrently. We recently saw a 40-year-old woman who received a…
For severe or refractory rejections, thymoglobulin/ATG is commonly employed in combination with steroids and B-cell targeted therapies when indicated. However, alemtuzumab could be more effective then thymoglobulin since it depletes not only T cells but also memory B…
Transplant physicians face the challenge to detect allograft rejection using non-sensitive biomarkers and clinical signs/symptoms. For kidney transplant, serum creatinine, urinalysis for proteinuria or hematuria, are so far used for screening for rejection and/or assessment of graft function….
It’s time for a quick nephro-centric summary of immune globulin use. Immune globulin, usually administered intravenously (IVIg), is made from pooled human plasma and used for a wide variety of human disease. It contains mostly IgG with various…
There have been a number of studies reported in the past month which broaden our understanding of the complexity of alloantibodies post kidney transplant. It is well recognized that the presence of donor specific anti-HLA antibodies (DSA) infers a…
Vascular rejection has been traditionally considered a severe form of acute rejection characterized by infiltration of mononuclear cells beneath the endothelium or by the presence of arteritis. Though initially reported as an aggressive form of T-cell mediated rejection…
One of the frequent situations that we face in the renal transplant clinic is the patient in otherwise good condition who presents with a slight rise in serum creatinine. Although this is sometimes due to reversible causes, such…
Acute humoral or antibody-mediated rejection (AMR) is attributed to the presence of alloantibodies against the graft, which could be either antibodies against human leukocyte antigens (HLAs) Class I and/or II , non-HLA antigens or endothelial antigens. Diagnosis of…
For the past 5 years, alloantibody measurement has become a standard of practice in recipients of kidney transplants experiencing worsening allograft function. This week, I admitted a patient who had a rising creatinine and on biopsy mild-moderate interstitial…