[en] Renal allograft rejection involves many mechanisms of innate and adaptive immunity, responsible for parenchymal inflammatory lesions that negatively impact the long-term outcomes of the renal allograft. The heterogeneous presentations of rejections in terms of clinical, biological and histological aspects make them difficult to manage in daily clinical practice. Indeed, current therapeutic strategies are disappointing in term of long-term outcomes, including graft survival. In this article, we will discuss the main effector mechanisms of rejection and their histological classification, as well as the existing treatments and those currently under evaluation. [fr] Le rejet du greffon rénal fait intervenir de nombreux mécanismes de l’immunité innée et adaptative, responsables de lésions inflammatoires parenchymateuses impactant négativement le devenir au long cours du greffon rénal. La grande hétérogénéité dans la présentation clinique, biologique et histologique des rejets de greffe en fait des entités difficiles à prendre en charge en pratique clinique quotidienne. En effet, les stratégies thérapeutiques actuelles montrent des résultats assez décevants pour le traitement des rejets, ce qui a comme conséquence une diminution significative de la survie des greffons. Nous aborderons dans cet article les principaux mécanismes effecteurs des rejets, leur classification histologique ainsi que les traitements existants et en cours de validation.
Disciplines :
Urology & nephrology
Author, co-author :
ERPICUM, Pauline ; Centre Hospitalier Universitaire de Liège - CHU > > Service de néphrologie
BONVOISIN, Catherine ; Centre Hospitalier Universitaire de Liège - CHU > > Service de néphrologie
GROSCH, Stéphanie ; Centre Hospitalier Universitaire de Liège - CHU > > Service de néphrologie
BOVY, Christophe ; Centre Hospitalier Universitaire de Liège - CHU > > Service de néphrologie
Pinto Coelho, Tiago ; Université de Liège - ULiège > GIGA Cardio. Sc. - Lab. of Translational Res. in Nephrology
DETRY, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie abdo, sénologique, endocrine et de transplantation
JOURET, François ; Centre Hospitalier Universitaire de Liège - CHU > > Service de néphrologie
WEEKERS, Laurent ; Centre Hospitalier Universitaire de Liège - CHU > > Service de néphrologie
BOUQUEGNEAU, Antoine ; Centre Hospitalier Universitaire de Liège - CHU > > Service de néphrologie
Language :
French
Title :
Diagnostic et prise en charge thérapeutique du rejet en transplantation rénale.
Alternative titles :
[en] Diagnosis and management of renal allograft rejection.
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