medigraphic.com

2005, Number 1

<< Back Next >>

Rev Hosp Jua Mex 2005; 72 (1)

Rescue therapy in chronic nephropathy of the transplant. Two hospital centers experience

Gómez TJC, González TVM , Bazán BA, Jiménez DA, Portilla FVH, González GA, Pérez GN, Paz SP

Language: Spanish
References: 19
Page: 4-9
PDF size: 69.38 Kb.


ABSTRACT

Objective. To determinate which is the best rescue therapy in kidney transplant patients, which developed chronic nephropathy diagnosed in two majors’ centers. Methods. We made a retrospective, longitudinal, descriptive study. 16 patients were identified who kidney transplant was made in the Juarez of Mexico Hospital and in the Medical Center La Raza; which developed chronic nephropathy diagnosed by biopsy and who were treated with rescue therapy based in tacrolimus, sirolimus, micofenolato and prednisona. Results. We found an improved with the use of sirolimus and micofenolato, with a recovery rate of the kidney function of 45-60% after 4 months of treatment, this was evaluated with the measuring of seric levels of creatinine, and glomerular filtration rate at the beginning and after 4 months of treatment. Conclusions. The association of sirolimus and micofenolato stabilize the transplant kidney function and allows to improve the overall survival of the patients with chronic nephropathy of the transplant kidney.


REFERENCES

  1. Allen RD, Chapman JR. Early renal transplant dysfunction. In: Allen, Chapman (eds). A Manual of Renal Transplantation. London: Edward Arnold, 1994: 144-67.

  2. Burdick JF, Racusew LC, Solez K, Williams GM. Kidney Transplant Rejection: Diagnosis and Treatment (2th ed.). New York: Marcel Dekker, 1992.

  3. Hariharan S, Johnson CP, Bresnahan BA y cols. Improved graft survival after renal transplantation in the United States 1988 to 1996. N Eng J Med 2000; 342: 605-12.

  4. Hayry P. Aspects of allograft rejection I: Molecular pathology of acute and chronic rejection. Transplant Rev 1995; 9: 113.

  5. Sollez K, Vincenti F, Filo R. US FK506 Kidney Transplant Study Group: Prevalence of chronic allograft nephropathy and analysis of predictive factors: Results of 2-year protocol biopsies from a US multicenter study. Transplantation 1998; 65: S82A.

  6. Solez y cols. International standarization of criteria for the histologic diagnosis of renal allograft rejection. The Banff working classification of kidney transplant pathology. Kidney Int 1993; 44: 411.

  7. Danovitch G. Forum del Kidney Int. Immunosuppressive medications for renal transplantation. A multiple choice question. Kidney Int 2001; 19: 388-402.

  8. Van der Heide JJH, Bilo HJG, Donker JM, Wilmink JM, Tegzess AM. Effect of dietary fish oil on renal function and rejection in cyclosporine-treated recipients of renal transplants. N Engl J Med 1993; 329: 769-73.

  9. Corey HE, Greifer I, Greenstein SM. The fractional excretion of urea: a new diagnostic test for acute renal allograft rejection. Pediatr Nephrol 1993; 7: 268-72.

  10. Sollinger HW, Belzer FO, Deierhoi MH y cols. RS-61443: Rescue therapy in refractory kidney transplant rejection. Transplant Proc 1993; 25: 689-99.

  11. Ojo AO, Meier-Kriesche HU, Hanson JA y cols. Mycophenolate Mofetil reduces late renal allograft loss independent of acute rejection, Transplantation 2000; 69: 2405-9.

  12. Shapiro R, Jordan ML, Scantlebury VP y cols. A prospective, randomized trial od tacrolimus/prednisone versus tacrolimus/ prednisone/mycophenolate mofetil in renal transplant recipients. Transplantation 1999; 67: 411-5.

  13. Weir M, Anderson L, Fink JC y cols. A novel approach to the treatment of chronic allograft nephropathy. Transplantation 1998; 65: 1504-6.

  14. European Mycophenolate Mofetil Cooperative Study Group. Mycophenolate mofetil in renal transplantation: 3-year results from the placebo-controlled trial. Transplantation 1999; 68: 391-96.

  15. Grinyó JM, Gil-Vernet S, Serón D y cols. Steroid withdrawal in mycophenolate mofetil-treated renal allograft recipients. Transplantation 1997; 63: 1688-90.

  16. Hueso M, Bover J, Serón D y cols. Low-dose of cyclosporine and mycophenolate mofetil in renal allograft recipients with suboptimal renal function. Transplantation 1998; 66: 1727-31.

  17. Groth CG, Bäckman L, Morales JM y cols., for the Sirolimus European Transplant Study Group. Sirolimus (rapamicyn)-based therapy in human renal transplantation. Transplantation 1999; 67: 1036-42.

  18. Morelon E, Mamzer-Bruneel MF, Peraldi MN, Kreis H. Sirolimus: a new promising immunosuppressive drug. Towards a rationale for its use in renal transplantation. Nephrol Dial Transplant 2001; 16: 18-20.

  19. Kreis H, Cisterne JM, Land W y cols. Sirolimus in association with mycofenolate mofetil induction for the prevention of acute graft rejection in renal allograft recipients. Transplantation 2000; 69: 1252-60.




2020     |     www.medigraphic.com