الفهرس 
POST RENAL TRANSPLANT REJECTION IN CAIRO UNIVERSITY CHILDREN`S HOSPITAL: TYPES, COURSE & OUTCOME
AbstractOnly 14 pages are availabe for public view
 |  | from | 209 |  |  |
| | | from | 209 | | |
Abstract
Introduction: Allograft rejection is a serious obstacle that should be tackled promptly for good graft outcome. Objective: The aim of this study was to investigate kidney rejection among renal transplant recipients being followed up in Kidney Transplantation Outpatient Clinic, Cairo University Children`s Hospital (CUCH) through years 2009-2017. Study design: Observational study involved 100 pediatric kidney recipients. Results: 24% developed at least one rejection episodes, 8% developed recurrent rejections. A total of 38 rejection episodes observed. Allograft biopsy showed 47.4% borderline changes, 26.3% AMR, 23.7% CMR & 2.6% mixed rejection. Pulse steroid used in 71.1%, ATG in 36.8%, plasma exchange and IVIG in 34.2% of rejection episodes. Response showed complete recovery in 39.5%, partial recovery in 47.4% and worsening creatinine in 13.2%. Mortality affected 6% mainly sepsis related, while graft failure affected 3%. Unrelated donor & non-compliance were associated with rejection (p<0.001 and p=0.002 respectively). 81% used CsA initially, 45% didn{u2019}t change their protocol, 71% used FK506 as a current protocol. Conclusion: donor source and immunosuppressive non-compliance were significant factors for developing kidney rejection, BPAR was correlated to low current eGFR. Single episodes carried better pathology (early changes) and better outcome, while rejection recurrence carried worse prognosis and poor response to antirejection therapy