Author/Editor		Buturović, Jadranka; Kandus, Aljoša
Title		Clinical aspects of rejection and treatment
Type		članek
Source		In: Bren AF, Ferluga D, Olsen S, et al, editors. Proceedings of the International conference on transplantation with emphasis on kidney; 1998 Oct 8-9; Ljubljana, Slovenia. Ljubljana: Medical faculty, Institute of pathology,
Publication year		1998
Volume		str. 57-9
Language		eng
Abstract		The main clinical sign of kidney graft rejection is deterioration of renal function, usually assessed as the rise in serum creatinine in everyday clinical work. Today, in the era of potent immunossuppressive drugs systemic symptoms of rejection occur rarely. Renal core biopsy is the standard procedure for diagnosi of rejection and is usually perofmed after all other possible causes of graft failure are excluded (vascular problems, urinary tract obstruction and leak, hypovolemia). Ultrasound-Doppler examination of renal transplant is the first step in diagnostic work-up, other imaging studies (scintigraphy, angiography etc.) being used if necessary. Methylprednisolone pulses therapy for 3-5 days is the standard therapeutic approach and can be started before histopathologic results are available. If there is no satisfactory response to steroids proceedings to antilymphocyte agents is necessary, either as monoclonal (OKT3) or polycloncal antilymphocyte agents. For particular severe of vascular rejection OKT-3 may be the best first-line option.
Descriptors		GRAFT REJECTION KIDNEY TRANSPLANTATION METHYLPREDNISOLONE ANTILYMPHOCYTE SERUM KIDNEY DISEASES