Primary Graft Dysfunction After Zero-Mismatch Kidney Transplantation Secondary to Early Biopsy-Proven Acute Cell-Mediated Rejection: Case Report

Transplant Proc. 2015 Sep;47(7):2223-6. doi: 10.1016/j.transproceed.2015.07.016.

Abstract

We report a case of primary renal allograft dysfunction and early acute cell-mediated rejection after a 12/12 HLA antigen zero-mismatch (0MM) transplant. The recipient was a 40-year-old white man who was highly allosensitized, with a calculated panel reactive antibody score of 100%. In posteroperative day 1 the recipient remained anuric and underwent dialysis because of hyperkalemia. Graft biopsy showed early acute cellular rejection, Banff grade 2B. No evidence of antibody-mediated rejection was observed. To our knowledge, this case is the 1st to report early cell-mediated rejection after 12/12 HLA antigen 0MM kidney transplantation. This case suggests that highly sensitized candidates are at high immunologic risk even in the context of 0MM kidney transplantation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biopsy
  • Flow Cytometry
  • Glomerulonephritis, IGA / immunology
  • Glomerulonephritis, IGA / surgery*
  • Graft Rejection / immunology*
  • HLA Antigens / immunology*
  • Histocompatibility Testing
  • Humans
  • Kidney Failure, Chronic / immunology
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation
  • Male
  • Primary Graft Dysfunction / diagnosis*
  • Primary Graft Dysfunction / therapy
  • Transplantation, Homologous
  • Treatment Outcome

Substances

  • HLA Antigens