Rejection of the kidney transplant
Here are the most important action points to consider in case of Rejection of the kidney transplant
1. A systematic, algorithmic approach to Acute Kidney Injury in the kidney transplant patient is highly recommended. Not all Acute Kidney Injury is rejection.
2. When the acute rejection of the of the kidney transplant is confirmed, always the possibility of inadequate immunosuppression should be considered.
3. Acute Auto immune Mediated Rejection includes documentation of circulating DSA, C4d staining in the peritubular capillaries, and allograft pathology consistent with this diagnosis. However, C4d negative Auto immune Mediated Rejection is a recognized form of Auto immune Mediated Rejection.
4. The principle cause of long term graft loss is the Transplant glomerulopathy. The levels of serum creatinine and Proteinuria may be stable and these parameters increase only after significant pathological damage has been done.
5. Certain multiple factors, both alloantigen-dependent and alloantigen-independent, likely appear to contribute to the pathogenesis of chronic graft dysfunction.
