Acute antibody-mediated rejection limited to medullary lesions in following ABO-incompatible living donor kidney transplantation
Anatomical differences between the renal cortex and medulla may influence inflammatory responses. Owing to the difficulty in diagnosing rejections from the medulla, rejection is usually diagnosed through the cortex. However, previous studies have shown that there are no significant differences in re...
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| Format: | Article |
| Language: | English |
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Korean Society for Transplantation
2021-03-01
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| Series: | Korean Journal of Transplantation |
| Subjects: | |
| Online Access: | http://journaleditor.inforang.com/journal/view.html?doi=10.4285/kjt.20.0047 |
| _version_ | 1827365372310847488 |
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| author | A Young Kim Kyu Hyang Cho Jong Won Park Jun Young Do Man-Hoon Han Yong-Jin Kim Seok Hui Kang |
| author_facet | A Young Kim Kyu Hyang Cho Jong Won Park Jun Young Do Man-Hoon Han Yong-Jin Kim Seok Hui Kang |
| author_sort | A Young Kim |
| collection | DOAJ |
| description | Anatomical differences between the renal cortex and medulla may influence inflammatory responses. Owing to the difficulty in diagnosing rejections from the medulla, rejection is usually diagnosed through the cortex. However, previous studies have shown that there are no significant differences in renal cortical and medullary lesions in acute allograft rejection. A 60-year-old man with a history of diabetic nephropathy underwent kidney transplant from a living unrelated donor at our hospital in August 2019. Three days after surgery, his urine output suddenly decreased, whereas the serum creatinine levels increased. A kidney biopsy showed only medullary lesions with positive C4d-staining and a Banff score of PTC grade 3. He was diagnosed with acute antibody-mediated rejection (AMR) and treatment was initiated. He did not respond to conventional treatments, including plasma exchange and intravenous immunoglobulin, but his general condition improved after bortezomib administration. There have been a few cases of acute AMR limited to medullary lesions. We consider that rejection cannot be excluded even if the lesions are confined to the medulla. |
| first_indexed | 2024-03-08T08:27:23Z |
| format | Article |
| id | doaj.art-5df68352cb3746da98eb3d2bff2528b1 |
| institution | Directory Open Access Journal |
| issn | 2671-8790 |
| language | English |
| last_indexed | 2024-03-08T08:27:23Z |
| publishDate | 2021-03-01 |
| publisher | Korean Society for Transplantation |
| record_format | Article |
| series | Korean Journal of Transplantation |
| spelling | doaj.art-5df68352cb3746da98eb3d2bff2528b12024-02-02T04:20:12ZengKorean Society for TransplantationKorean Journal of Transplantation2671-87902021-03-01351535810.4285/kjt.20.0047kjt.20.0047Acute antibody-mediated rejection limited to medullary lesions in following ABO-incompatible living donor kidney transplantationA Young Kim0Kyu Hyang Cho1Jong Won Park2Jun Young Do3Man-Hoon Han4Yong-Jin Kim5Seok Hui Kang6Division of Nephrology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, KoreaDivision of Nephrology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, KoreaDivision of Nephrology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, KoreaDivision of Nephrology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, KoreaDepartment of Pathology, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Pathology, School of Medicine, Kyungpook National University, Daegu, KoreaDivision of Nephrology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, KoreaAnatomical differences between the renal cortex and medulla may influence inflammatory responses. Owing to the difficulty in diagnosing rejections from the medulla, rejection is usually diagnosed through the cortex. However, previous studies have shown that there are no significant differences in renal cortical and medullary lesions in acute allograft rejection. A 60-year-old man with a history of diabetic nephropathy underwent kidney transplant from a living unrelated donor at our hospital in August 2019. Three days after surgery, his urine output suddenly decreased, whereas the serum creatinine levels increased. A kidney biopsy showed only medullary lesions with positive C4d-staining and a Banff score of PTC grade 3. He was diagnosed with acute antibody-mediated rejection (AMR) and treatment was initiated. He did not respond to conventional treatments, including plasma exchange and intravenous immunoglobulin, but his general condition improved after bortezomib administration. There have been a few cases of acute AMR limited to medullary lesions. We consider that rejection cannot be excluded even if the lesions are confined to the medulla.http://journaleditor.inforang.com/journal/view.html?doi=10.4285/kjt.20.0047kidney transplantation; rejection; bortezomib; medullary lesion |
| spellingShingle | A Young Kim Kyu Hyang Cho Jong Won Park Jun Young Do Man-Hoon Han Yong-Jin Kim Seok Hui Kang Acute antibody-mediated rejection limited to medullary lesions in following ABO-incompatible living donor kidney transplantation Korean Journal of Transplantation kidney transplantation; rejection; bortezomib; medullary lesion |
| title | Acute antibody-mediated rejection limited to medullary lesions in following ABO-incompatible living donor kidney transplantation |
| title_full | Acute antibody-mediated rejection limited to medullary lesions in following ABO-incompatible living donor kidney transplantation |
| title_fullStr | Acute antibody-mediated rejection limited to medullary lesions in following ABO-incompatible living donor kidney transplantation |
| title_full_unstemmed | Acute antibody-mediated rejection limited to medullary lesions in following ABO-incompatible living donor kidney transplantation |
| title_short | Acute antibody-mediated rejection limited to medullary lesions in following ABO-incompatible living donor kidney transplantation |
| title_sort | acute antibody mediated rejection limited to medullary lesions in following abo incompatible living donor kidney transplantation |
| topic | kidney transplantation; rejection; bortezomib; medullary lesion |
| url | http://journaleditor.inforang.com/journal/view.html?doi=10.4285/kjt.20.0047 |
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