Case Report: Suspected Hyperacute Rejection During Living Kidney Transplantation.

Autor: Shimizu T; Department of Urology and Transplant Surgery, Toda Chuo General Hospital, Saitama, Japan; Department of Urology, Tokyo Women's Medical University, Tokyo, Japan. Electronic address: houichi0114@yahoo.co.jp., Iida S; Department of Urology and Transplant Surgery, Toda Chuo General Hospital, Saitama, Japan; Department of Urology, Tokyo Women's Medical University, Tokyo, Japan., Omoto K; Department of Urology, Tokyo Women's Medical University, Tokyo, Japan., Inui M; Department of Urology, Tokyo Women's Medical University, Yachiyo Medical Center, Chiba, Japan., Nozaki T; Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan., Toma H; Department of Urology and Transplant Surgery, Toda Chuo General Hospital, Saitama, Japan., Takagi T; Department of Urology, Tokyo Women's Medical University, Tokyo, Japan., Ishida H; Department of Organ Transplant Medicine, Tokyo Women's Medical University, Tokyo, Japan.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2023 May; Vol. 55 (4), pp. 1089-1091. Date of Electronic Publication: 2023 May 04.
DOI: 10.1016/j.transproceed.2023.04.020
Abstrakt: Background: We report a case of suspected hyperacute rejection during living kidney transplantation.
Case Report: A 61-year-old man underwent kidney transplantation in November 2019. Before the transplantation, immunologic tests revealed the presence of anti-HLA antibodies but not donor-specific HLA antibodies. The patient was intravenously administered 500 mg of methylprednisolone (MP) and basiliximab before perioperative blood flow reperfusion. After blood flow restoration, the transplanted kidney turned bright red and then blue. Hyperacute rejection was suspected. After the intravenous administration of 500 mg of MP and 30 g of intravenous immunoglobulin, the transplanted kidney gradually changed from blue to bright red. The initial postoperative urine output was good. On the 22nd day after the renal transplantation, the patient was discharged with a serum creatinine level of 2.38 mg/dL, and the function of the transplanted kidney gradually improved.
Conclusions: In this study, non-HLA antibodies may have been a cause of the hyperacute rejection, which was managed with additional perioperative therapies.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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