Makindo Medical Notes"One small step for man, one large step for Makindo" |
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This occurs immediately due to ABO and HLA incompatibility. The presence of pre-existing antibodies against the transplant antigens causes rapid thrombosis, complement activation, and organ failure. Hyperacute rejection is a medical emergency and should never occur if proper matching is done.
Occurs within the first 3 months after transplantation, characterized by worsening renal function, fever, and localized pain. Biopsy is typically performed (easier as the kidney is in the pelvis). Treatment includes steroids, OKT3, and Anti-thymocyte globulin. This form of rejection is primarily T-cell mediated, and increased immunosuppression generally helps manage it.
Occurs after 3 months and is marked by fibrosis and the presence of inflammatory cells. Unfortunately, it does not respond to immunosuppressive drugs. The differential diagnosis includes Ciclosporin nephrotoxicity, which causes elevated creatinine levels and may require renal biopsy for confirmation.