Local Graft Irradiation for Kidney Allograft Rejection: A Case Series and Review of the Literature

AuthorMohammad Kazem Fallahzadehen
AuthorSarah Khanen
AuthorGazi B. Zibarien
AuthorSandeep Patilen
AuthorNeeraj Singhen
Issued Date2014-05-01en
AbstractIntroduction:: Due to its immunosuppressive properties, local graft irradiation (LGI) has been proposed as a second line therapy for treatment of acute kidney rejection. Case Presentation:: In this case-series we report 6 patients with biopsy proven acute kidney allograft rejection refractory to conventional antirejection therapy who underwent LGI for treatment of acute rejection at our center. Three of these patients had living donor transplants, 2 had deceased donor transplants, and one had received a simultaneous kidney/pancreas transplant. All patients were treated with anti thymocyte-globulin or muromonab-CD3, and intravenous steroids for initial treatment of rejection. Three patients also received intravenous immunoglobulin. LGI was tried as a last resort and was well tolerated and resulted in either improvement or stabilization of renal function in 5 patients. One patient could not be given the complete course of chemical immunosuppression for treatment of rejection due to concomitant cryptococcal meningitis and was switched to LGI with good short-term response. Discussion:: Our results suggest that LGI could be considered a second line therapy to the conventional anti-rejection therapy for patients with refractory acute kidney allograft rejection, or for patients who cannot receive systemic immunosuppression due to severe infection.en
DOIhttps://doi.org/10.5812/numonthly.16262en
KeywordRejectionen
KeywordGraften
KeywordImmunosuppressionen
KeywordKidneyen
KeywordRadiotherapyen
KeywordTransplantationen
PublisherBrieflandsen
TitleLocal Graft Irradiation for Kidney Allograft Rejection: A Case Series and Review of the Literatureen
TypeCase Reporten

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