ABSTRACT
Operational tolerance is defined as stable renal function in transplants without immunosuppression for at least 1 year. We present histological assessments of two patients with operational tolerance. The first withdrew immunosuppression in 2005 and presents stable renal function (creatinine 1.5 mg/dL) without proteinuria. The biopsy showed mild chronic tubulointerstitial changes without inflammation. The second withdrew immunosuppression in 2009 and maintains stable renal function (creatinine 1.6 mg/dL) with mild proteinuria. Histology showed chronic humoural rejection and Class II anti-human leukocyte antigen antibodies were detected. These cases suggest that a renal biopsy may be useful to rule out subclinical pathology in patients with operational tolerance.
Subject(s)
Antibodies, Antineutrophil Cytoplasmic/blood , Antibodies, Monoclonal, Murine-Derived/therapeutic use , Gingival Hemorrhage/etiology , Glomerulonephritis/etiology , Systemic Vasculitis/drug therapy , Adrenal Cortex Hormones/therapeutic use , Aged , Cyclophosphamide/therapeutic use , Drug Therapy, Combination , Humans , Immunosuppressive Agents/therapeutic use , Lung Diseases/etiology , Male , Mycophenolic Acid/analogs & derivatives , Mycophenolic Acid/therapeutic use , Recurrence , Remission Induction , Renal Dialysis , Rituximab , Systemic Vasculitis/complications , Systemic Vasculitis/immunologyABSTRACT
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