Therapeutic response and monitoring of antibody-mediated renal graft rejection

Authors

  • Yumar Alfredo Hurtado-Castillo Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Nefrología. León, Guanajuato, México https://orcid.org/0009-0007-4479-4251
  • Juana Alejandra Serrano-Ramírez Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Nefrología. León, Guanajuato, México https://orcid.org/0009-0007-7893-8225
  • José Oscar Juaréz-Sánchez Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Nefrología. León, Guanajuato, México https://orcid.org/0000-0002-3560-7879
  • Itzy Maely Gaytán-Campos Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Nefrología. León, Guanajuato, México https://orcid.org/0009-0000-5720-4774

DOI:

https://doi.org/10.5281/zenodo.15178468

Keywords:

Kidney Transplantation, Graft Rejection, Antibodies

Abstract

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.

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Author Biographies

  • Yumar Alfredo Hurtado-Castillo, Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Nefrología. León, Guanajuato, México

    Dr. Hurtado Castillo Yumar Alfredo

    Residente de Nefrología del Instituto Mexicano del Seguro Social; Unidad Médica de Alta Especialidad #1 Hospital de Especialidades Centro Médico Nacional del Bajío. León, Guanajuato

    Residente de 3er año de la Especialidad en Nefrología del Servicio de Nefrología. León, Guanajuato.

  • Juana Alejandra Serrano-Ramírez, Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Nefrología. León, Guanajuato, México

    Dr. Serrano Ramírez Juana Alejandra

    Médico Nefróloga del Instituto Mexicano del Seguro Social; adscrito a la Unidad Médica de Alta Especialidad #1 Hospital de Especialidades Centro Médico Nacional del Bajío. León, Guanajuato

    Profesor adjunto de la Especialidad en Nefrología del Servicio de Nefrología. León, Guanajuato.

  • José Oscar Juaréz-Sánchez, Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Nefrología. León, Guanajuato, México

    Dr. Juárez Sánchez José Oscar.

    Médico Nefrólogo del Instituto Mexicano del Seguro Social; adscrito a la Unidad Médica de Alta Especialidad #1 Hospital de Especialidades Centro Médico Nacional del Bajío. León, Guanajuato

    Profesor adjunto de la Especialidad en Nefrología del Servicio de Nefrología. León, Guanajuato.
     

  • Itzy Maely Gaytán-Campos, Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Nefrología. León, Guanajuato, México

    Dra. Gaytán Campos Itzy Maely

    Residente de Nefrología del Instituto Mexicano del Seguro Social; Unidad Médica de Alta Especialidad #1 Hospital de Especialidades Centro Médico Nacional del Bajío. León, Guanajuato

    Residente de 3er año de la Especialidad en Nefrología del Servicio de Nefrología. León, Guanajuato.

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Published

2025-06-19

Issue

Section

Original Articles