Therapy in the Course of Kidney Graft Rejection—Implications for the Cardiovascular System—A Systematic Review

Abstract

Kidney graft failure is not a homogenous disease and the Banff classification distinguishes several types of graft rejection. The maintenance of a transplant and the treatment of its failure require specific medications and differ due to the underlying molecular mechanism. As a consequence, patients suffering from different rejection types will experience distinct side-effects upon therapy. The review is focused on comparing treatment regimens as well as presenting the latest insights into innovative therapeutic approaches in patients with an ongoing active ABMR, chronic active ABMR, chronic ABMR, acute TCMR, chronic active TCMR, borderline and mixed rejection. Furthermore, the profile of cardiovascular adverse effects in relation to the applied therapy was subjected to scrutiny. Lastly, a detailed assessment and comparison of different approaches were conducted in order to identify those that are the most and least detrimental for patients suffering from kidney graft failure.

Solid organ transplantation and gut microbiota: a review of the potential immunomodulatory properties of short-chain fatty acids in graft maintenance

“…, age, overweight, hypertension) ( Joosten et al., 2005 ). Chronic TCMR is less common and according to the Banff classification, the criteria include interstitial inflammation and fibrosis, tubulitis and tubular atrophy ( Loupy et al., 2020 ; Mizera et al., 2023 ).…”

“…The underlying mechanisms are complex and involve both adaptive and innate immune responses, failure to maintain sufficient immunosuppression and other risk factors (e.g., age, overweight, hypertension) (Joosten et al, 2005). Chronic TCMR is less common and according to the Banff classification, the criteria include interstitial inflammation and fibrosis, tubulitis and tubular atrophy (Loupy et al, 2020;Mizera et al, 2023).…”