title: Progression of the renal graft: treatment of acute rejection based on a biopsy against a presumptive diagnosis.
abstract: The aim of this study was to compare the progression of renal grafts following treatment of an acute rejection event based on the histological diagnosis of a graft biopsy compared to a presumptive (clinical and laboratory) diagnosis. A historical cohort was used to study 44 patients undergoing a living haploidentical related donor renal transplant, using a similar immunosuppressive treatment: cyclosporine, azathioprine, and prednisone. Acute rejection events were treated with methylprednisolone (250 mg for 3 to 5 days) based on a histological diagnosis (biopsy group = 14) or on a clinical and laboratory diagnosis (presumptive group = 30), which consisted of an elevation over 20% in plasma creatinine in 24 hours and renal ultrasound or scintigraphy findings. The study demonstrated no significant difference in renal function (plasma creatinine) and other outcomes 2 years following transplantation in both groups. The results show that treatment of acute rejection based on a presumptive diagnosis is not a risk factor for unfavorable outcomes following 2 years of renal transplantation monitoring.
authors.affiliation: Faculdade de Ciências Médicas de Minas Gerais, Hospital Mater Dei, Belo Horizonte, Brazil. lasmar@superig.com.br
authors.forename: E P
authors.initials: EP
authors.lastname: Lasmar
authors.forename: M F
authors.initials: MF
authors.lastname: Lasmar
authors.forename: L F
authors.initials: LF
authors.lastname: Lasmar
authors.forename: L F C
authors.initials: LF
authors.lastname: Giordano
authors.forename: F
authors.initials: F
authors.lastname: Lucas
authors.forename: J M
authors.initials: JM
authors.lastname: Borges
mesh_terms: D000208:Acute Disease; D000328:Adult; D001706:Biopsy; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D016030:Kidney Transplantation / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D014463:Ultrasonography
chemical_list: D007166:Immunosuppressive Agents; D011239:Prednisolone; D003404:Creatinine; D011241:Prednisone