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

Area of Science:

• Nephrology
• Immunology
• Transplantation Medicine

Background:

• Kidney graft failure encompasses diverse rejection types, necessitating tailored treatment strategies.
• The Banff classification categorizes rejection, guiding therapeutic decisions based on underlying molecular mechanisms.
• Therapeutic interventions and their associated side effects vary significantly across different kidney transplant rejection subtypes.

Purpose of the Study:

• To compare current and innovative treatment regimens for various kidney transplant rejection types.
• To analyze the cardiovascular adverse effects associated with different therapeutic approaches.
• To identify the most and least detrimental treatment strategies for kidney graft failure.

Main Methods:

• Literature review and synthesis of existing data on kidney transplant rejection treatments.
• Comparative analysis of therapeutic regimens for active antibody-mediated rejection (ABMR) and T-cell mediated rejection (TCMR) subtypes.
• Evaluation of cardiovascular adverse event profiles linked to specific immunosuppressive therapies.

Main Results:

• Distinct treatment protocols are required for different forms of ABMR and TCMR, including chronic and active phases.
• Cardiovascular adverse effects are a significant concern, varying in prevalence and type depending on the immunosuppressive agents used.
• Certain treatment approaches demonstrate a more favorable risk-benefit profile in managing kidney graft failure.

Conclusions:

• Personalized treatment strategies are crucial for optimizing outcomes in kidney transplant recipients with graft failure.
• Careful consideration of cardiovascular risks is essential when selecting therapies for different rejection types.
• Further research into novel, safer therapeutic options is warranted to mitigate treatment-related morbidities.