Your browser doesn't support javascript.
loading
Better understanding of transplant glomerulopathy secondary to chronic antibody-mediated rejection.
Remport, Adam; Ivanyi, Bela; Mathe, Zoltan; Tinckam, Kathryn; Mucsi, Istvan; Molnar, Miklos Z.
Afiliação
  • Remport A; Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.
  • Ivanyi B; Department of Pathology, University of Szeged, Szeged, Hungary.
  • Mathe Z; Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.
  • Tinckam K; Division of Nephrology, Department of Medicine,University Health Network, University of Toronto, Toronto, Ontario, Canada.
  • Mucsi I; Division of Nephrology, Department of Medicine,University Health Network, University of Toronto, Toronto, Ontario, Canada.
  • Molnar MZ; Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
Nephrol Dial Transplant ; 30(11): 1825-33, 2015 Nov.
Article em En | MEDLINE | ID: mdl-25473123
Transplant glomerulopathy (TG) is generally accepted to result from repeated episodes of endothelial activation, injury and repair, leading to pathological abnormalities of double contouring or multi-layering of the glomerular basement membrane. TG is a major sequel of chronic active antibody-mediated rejection (cABMR), from pre-existing or de novo anti-HLA antibodies. Hepatitis C infection, thrombotic microangiopathy or other factors may also contribute to TG development. TG prevalence is 5-20% in most series, reaching 55%, in some high-risk cohorts, and is associated with worse allograft outcomes. Despite its prevalence and clinical significance, few well-studied treatment options have been proposed. Similar to desensitization protocols, plasmapheresis with or without immunoabsorption, high-dose intravenous immunoglobulin, rituximab, bortezomib and eculizumab have been proposed in the treatment of TG due to cABMR individually or in various combinations. Robust clinical trials are urgently needed to address this major cause of allograft loss. This review summarizes the current knowledge of the epidemiology, etiology, pathology, and the preventive and treatment options for TG secondary to cABMR.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transplante de Rim / Glomerulonefrite / Rejeição de Enxerto / Isoanticorpos / Glomérulos Renais Tipo de estudo: Guideline / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transplante de Rim / Glomerulonefrite / Rejeição de Enxerto / Isoanticorpos / Glomérulos Renais Tipo de estudo: Guideline / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2015 Tipo de documento: Article