RT Journal Article
T1 Clinical Case: Patient with Mixed Graft Rejection Four Days after Kidney Transplantation Developed Specific Antibodies against Donor Bw4 Specificities.
A1 Muñoz-Herrera, Claudia M
A1 Gutiérrez-Bautista, Juan Francisco
A1 López-Nevot, Miguel Ángel
K1 Banff classification
K1 anti-Bw4
K1 donor specific antibodies
K1 kidney rejection
K1 mixed rejection
AB Kidney transplantation, like other transplants, has the risk of producing graft rejection due to genetic differences between donor and recipient. The three known types of renal rejection are listed in the Banff classification: T-cell-mediated rejection (TCMR), antibody-mediated rejection (ABMR), and mixed rejection. The human leukocyte antigens (HLA) are highly polymorphic and may be the targets of donor-specific antibodies, resulting in ABMR. Therefore, prior to transplantation, it is necessary to analyze the HLA genotype of the donor and recipient, as well as the presence of DSA, in order to avoid hyperacute rejection. However, due to the shortage of kidneys, it is very difficult to find a donor and a recipient with completely matched HLA genotypes. This can trigger a future rejection of the kidney, as is reported in this work. We describe a patient who received a kidney transplant after a negative DSA test, who developed graft rejection with antibodies against the donor's HLA-Bw4 public epitope and lymphocytic infiltrate four days after transplantation, whose differential diagnosis was mixed rejection.
YR 2021
FD 2021-07-21
LK http://hdl.handle.net/10668/18468
UL http://hdl.handle.net/10668/18468
LA en
DS RISalud
RD Apr 6, 2025