[Rejection reaction. Elements of diagnosis, monitoring, therapeutic attitude in the case of kidney].
Allograft rejection reaction must be integrated in the broader sense of alloreactivity, i.e. involving a huge T cell repertoire with a high number of alloreactive precursors. This reaction is modulated by the particular immunological state induced by chronic renal insufficiency, by haemodialysis and by the primary kidney disease. The imperfect effect of current immunosuppressive drugs is illustrated by a sizeable proportion of grafts undergoing a chronic rejection process where many growth factors are involved. It has to be noted that allostimulating cells are different from target cells. At present, the therapeutical rejection involves corticosteroids and serotherapy, but it is hoped that new immunosuppressive drugs will increase the efficacy of the rejection crisis treatment.
Deglise-Favre
A
A
Service de Néphrologie, CHU de Bicêtre, Kremlin-Bicêtre.
Charpentier
B
B
D058186:Acute Kidney Injury / Q000276:immunology; D006084:Graft Rejection / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000276:immunology*; D016030:Kidney Transplantation / Q000009:adverse effects*
D007166:Immunosuppressive Agents
La réaction de rejet. Eléments de diagnostic, de surveillance, attitude thérapeutique dans le cas du rein.