Tenorio-Pacheco A, Felipe-Rojas J, Cárdenas-Rojas N

Language: Spanish
References: 7
Page: 96-100
PDF size: 908.47 Kb.

ABSTRACT

Kidney transplantation is the treatment of choice for patients with end-stage chronic kidney disease, as it provides improved survival and better quality of life compared to dialysis. We present the case of a 35-year-old female patient with stage V chronic kidney disease, arterial hypertension, and multiple complications associated with dialysis therapy, including infections, severe anemia, and progressive exhaustion of vascular access sites. Her clinical course, she developed significant immunological sensitization with elevated anti-HLA antibody levels, classifying her as high risk for transplantation. Due to the absence of viable vascular access and limited therapeutic options, a deceased-donor kidney transplant was performed, with a prolonged cold ischemia time exceeding 25 hours. In the postoperative period, the patient developed delayed graft function and biopsy-confirmed antibody-mediated rejection, requiring intensive immunosuppressive therapy and plasmapheresis. Subsequently, she showed progressive recovery of renal function with favorable clinical evolution. This case illustrates the complexity of kidney transplantation in highly sensitized patients with prolonged cold ischemia time and lack of vascular access, highlighting that even in adverse scenarios, transplantation can represent a viable and potentially lifesaving therapeutic option through a multidisciplinary and individualized approach.

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