Various Causes of Kidney Transplant Failure

Medical Video: Common Causes of Kidney Failure

It's been 66 years since the first time a kidney transplant was successfully carried out. Of course there are a lot of improvements in this kidney transplant. Especially in the last 10 years, the development in the success of kidney transplants has increased rapidly. The most recent data shows that 97% of donated kidneys function in the first month, 93% in the first year, and 83% in the first 3 years. Although the data is indeed quite satisfactory, these data also show that after 3 years, 17% of kidney transplants fail.

Many reasons behind the failure of kidney transplants. The most frequent reason is because the body of the kidney transplant recipient rejects the new kidney. This is caused by the immune system in kidney transplant recipients detecting foreign objects that enter the body, so the immune system builds forces to attack these foreign objects. Recently, researchers have discovered the secret behind why the bodies of kidney transplant recipients reject new kidneys in their bodies.

Two types of kidney rejection: acute rejection and chronic rejection

Before further explanation, you need to know in advance the types of bodily rejection against organ transplants.

Acute rejection is a type of rejection in the body that occurs no later than a year after kidney transplant surgery. While chronic rejection can only occur years of kidney transplant surgery.

Acute rejection is usually overcome by increasing the dose of drugs that suppress the immune system. This drug functions to control your immune system so it doesn't attack new kidneys in your body. While chronic rejection is usually referred to as refusal that cannot be treated and certainly causes the patient to lose his new organ. This assumption arises because the medical team cannot diagnose this rejection until the organ tissues are damaged. Until now, acute rejection and chronic rejection were considered as 2 different diseases.

However, a recent study led by Professor Daniel Salomon at the Scripps Research Institute shows that in fact, acute rejection and chronic rejection are not different diseases, but are caused by the same thing.

How can acute rejection develop into chronic rejection

The researchers used the method gene expression profiling. This method is used to see activity during acute rejection and chronic rejection takes place. This method can provide data for researchers comparing the activity of thousands of genes simultaneously to look for differences and similarities in genes in patients who experience acute rejection, chronic rejection, and those who are healthy at the same time.

The researchers involved 234 kidney transplant patients to undergo a kidney biopsy. The results of the study show that 80% of genes expressed in acute rejection are also expressed in tissues involved in chronic rejection. So actually, these two diseases are caused by the same thing.

The difference is, in cases of chronic rejection, doctors usually have reduced the dose of the immune system after the first year, due to the toxicity of the drug itself. As a result, the immune system's resistance level decreases until finally your immune system can fight this new kidney again. In fact, toxins from the drug can be defended by the immune system in the new kidney.

With this new research, new hope came about the treatment of chronic rejection of kidney transplants. It can be concluded that the treatment used to treat acute rejection can also be applied to chronic rejection. Because in fact, these two diseases are actually the same disease.

How to predict the failure of a kidney transplant?

Chronic rejection has a mechanism similar to cancer cells, where the disease spreads slowly and unknown, until a serious problem occurs in this new kidney. However, the research team found a new method for detecting the failure of new kidneys before reaching serious problems.

The new method used to detect this rejection utilizes fibrous interstitial tubular atrophy (IFTA). This type of wound in the kidney has been previously linked to an increased risk of kidney transplant rejection, but not an ongoing rejection. However, in this study, researchers were able to show that IFTA wounds were not only a sign of previous injuries, but were signs of an ongoing body rejection process. Previously IFTA wounds were rarely treated. However, after this study, the medical team needed to consider treating this wound.

From the results of this study, medical teams can consider the steps that can be taken for kidney transplant recipients. The researchers recommended the medical team to carry out biopsies on kidney transplant patients at regular intervals. Data about cellular activity in your body simultaneously resulting from this biopsy can help medical teams to detect early signs of acute rejection and chronic rejection.

The researchers also proposed to see cellular activity in your body with a blood test to prevent multiple biopsies. This blood test method can also help the medical team to measure the immune system response and work on immune system restraints at any time. This blood test method is being tested at the Clinical Trials in Organ Transplantation (CTOT).

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