Nhân một trường hợp điều trị thành công thải ghép thận cấp có sử dụng kháng thể kháng tế bào tuyến ức

Abstract

New immunosuppressive protocols and advanced surgical technique resulted in a major improvement in the outcome of kidney transplantation. A 43-year-old, male patient diagnosed with chronic glomerulonephritis. After the kidney transplantation, he had an acute cell-mediated kidney rejection diagnosed by biopsy and ATG treatment was immediately performed. The graft kidney function recovered after 01 week. And then, the patient had sepsis complication with urinary tract source. The antibiotics prescribed were Meronem 2g/day plus levofloxacin 0.5g/day. Blood and urine culture results were Escherichia coli. Five days later, patient was fully recovered and discharged with normal clinical presentation and laboratory tests. Discussion: The acute T-cell mediated rejection is a severe and common complication after kidney transplantation. It has many risk factors. Treatment of this complication was effective with short-time ATG (5 days). Complications of septicemia after taking ATG in patients with acute rejection are rare, had some risk factors, severe, requiring immediately broad-spectrum antibiotic treatment. Conclusion: Using ATG in acute T-cell mediated rejection was strongly effective. However, the its infection complication also significantly increased, needed prognosis, detection and timely management (prevention, ready for emergency management).