23yrs old recipient,Male,Bld group-B+ve,,Endstage kidney on biopsy.On dialysis for the last 8 months
Donor-Paternal uncle ,age 45,Bld group 0+ve , lap donor nephrectomy,slightly prolonged procedure.
Good perfusion Intra-op,Reduced urine output from DAY 1.
HLA 1,2,2 MISMATCH,CDC Cross match-ve,DSA Luminex -ve(twice before and after Transplant),
Simulect induction,TAC,MMF,STEROID
Tac levels -10
Day 5 biopsy -Glomerulitis,endarteritis,Severe ATN Anuric,dialysis dependent
DSA ,C4d negative
Given 3 doses pulse methyl pred,1 Plasma exchange and IV Ig (10gm) given. 500mg Rituximab given(375MG/M2).
Currently pt.has fever,so further treatment withhled
Given DSA ,C4d negative,is this non HLA Antibody mediated AMR or ??Ischemia re-perfusion injury
What are the chances of graft recovery in such cases.
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