Resumen

Introduction: Acute rejection has been identified as the main cause of renal graft dysfunction during the first year after transplantation; it is associated with chronic structural and functional damage, leading to graft loss and decreased patient survival. Material and methods: We conducted a retrospective and descriptive study reviewing the final biopsy reports of dysfunctional renal grafts obtained during the post-transplant period. Included patients were transplanted at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán between January 2007 and December 2011. Results: A total of 223 patients underwent renal transplantation during the study period; 222 biopsies were performed due to renal graft dysfunction in 118 patients (52.9%). Seventy four point five percent (74.5%) of patients developed graft dysfunction within the first year after transplantation. The main histopathological findings were immune-mediated events in both living donor (LDRTR) and deceased donor renal transplant recipients (DDRTR) but “borderline changes” was the most common diagnosis. The median time to the detection of immune phenomena as the cause of dysfunction was shorter in DDRTR, appearing within the first 4 months after transplantation. Conclusion: We observed an incidence of acute rejection of 11.8% during the first year after transplantation in LDRTR and 17.4% in DDRTR. Further studies are needed to determine the causes of these immunological events and their implications in the evolution of renal graft and patient survival.

Palabras clave: Renal transplantation renal graft dysfunction renal graft biopsy histopathological diagnosis acute rejection.

2013-12-18   |   706 visitas   |   Evalua este artículo 0 valoraciones

Vol. 65 Núm.5. Septiembre-Octubre 2013 Pags. 412-419 Rev Invest Clin 2013; 65(5-ENGLISH)