Kidney transplant rejection in hla-sensitized patients risk factors and immunosuppressive strategies.

Abstract

Background:In kidney transplant recipients who are sensitized to donor cells, rejection remains the leading cause of graft failure. The presence of preformed antibodies against donor human leukocyte antigen (HLA) molecules predisposes these patients to heightened immune-mediated rejection of the allograft. Careful consideration of individual risk factors, along with the judicious use of immunosuppressive therapies, is essential to improving transplant outcomes in sensitized patients.

Objectives: To identify the factors contributing to graft rejection in HLA-sensitized kidney transplant recipients and to evaluate the most effective immunosuppressive strategies for this high-risk population.

Study design: A Cross-Sectional Study.

Place and duration of study: Department Of Nephrology Mercy Teaching Hospital Peshawar from Jan 2023 to Jan 2024

Methods:

This cross-sectional study was conducted at the Department of Nephrology, Mercy Teaching Hospital, Peshawar, from January 2023 to January 2024. Data were collected from HLA-sensitized kidney transplant recipients to assess risk factors for graft rejection and evaluate the effectiveness of different immunosuppressive strategies.

Results:

On average, the patients included were 47.8 years old (with a standard deviation of 12.4 years). The rate of rejection was much higher for sensitized participants (p < 0.01) compared to individuals who were not sensitized. Whereas elevated DSA and a history of previous transplants were helpful in predicting rejection. The outcomes showed that using plasmapheresis, IVIg and induction therapy helped improve the survival of grafts (p = 0.03).

Conclusion:

Patients who are sensitive to HLA are more likely to reject a kidney transplant. When rejection is spotted early and the right immunosuppressant therapies are used, the chances of rejection and graft loss are lowered.