16h30davidsaitovitch
DESCRIPTION
- PowerPoint PPT PresentationTRANSCRIPT
![Page 1: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/1.jpg)
Desensibilização em transplante Desensibilização em transplante renal – experiência da PUCRSrenal – experiência da PUCRS
(relato de caso)(relato de caso)
HOSPITAL SÃO LUCAS DA PUCRS
SERVIÇO DE NEFROLOGIA
2012
David Saitovitch
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
IgA Nephropathy
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G.C.V.J., 49-year-old, Brazilian, caucasian, female
Case presentation
IgA Nephropathy
dialysis since 07/2000
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
IgA Nephropathy
2 pregnancies, 10 blood transfusions, 1st kidney tx 06/2003
dialysis since 07/2000
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
IgA Nephropathy
Primary non-function....
2 pregnancies, 10 blood transfusions, 1st kidney tx 06/2003
dialysis since 07/2000
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
IgA Nephropathy
Primary non-function.... Etiology????
2 pregnancies, 10 blood transfusions, 1st kidney tx 06/2003
dialysis since 07/2000
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
HemodialysisWaiting list
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
HemodialysisWaiting list
CMs
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
HemodialysisWaiting list
CMs → +
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
HemodialysisWaiting list
CMs → +
PRA (CDC) → >90%
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
HemodialysisWaiting list
vascular access...
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
HemodialysisWaiting list
vascular access...dificult!
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Peritoneal dialysis 03/2006
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Peritoneal dialysis 03/2006
Peritonitis
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
ultrafiltration...failure!
Peritoneal dialysis 03/2006
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis 03/2008
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
vascular access...dificult!
Hemodialysis 03/2008
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
vascular access...dificult!
Priority on the waiting list (2009)!
Hemodialysis 03/2008
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis
Priority on the waiting list!
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis
Priority on the waiting list!
↑CMs
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis
Priority on the waiting list!
↑CMs → +
![Page 25: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/25.jpg)
G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis
Priority on the waiting list!
↑CMs → +
2009
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis
Priority on the waiting list!
PRA (CDC) → >95%
![Page 27: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/27.jpg)
G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis
Priority on the waiting list!
PRA (Flow) → >95%
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis
Priority on the waiting list!
Desensitization protocol
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis
Priority on the waiting list!
Desensitization protocol
ivig
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis
Priority on the waiting list!
Desensitization protocol
ivig2g/Kg (monthly)
2010
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis
Priority on the waiting list!
Desensitization protocol
ivig2g/Kg (monthly)
2010
CMs → +
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis
Priority on the waiting list!
Desensitization protocol
ivig2g/Kg (monthly)
2010
CMs → +
PRA...??
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis
Priority on the waiting list!
Desensitization protocol
PP/ivig0.1g/Kg
Jan 2011
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Hemodialysis
Priority on the waiting list!
Desensitization protocol
PP/ivig0.1g/Kg
Jan 2011
Deceased donor
allograft 21/02/11
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Deceased donor
allograft 21/Feb/11
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Deceased donor
allograft 21/Feb/11
AA BB DRDR
RecipientRecipient 2,242,24 35,6535,65 13,1613,16
DonorDonor 2, -2, - 51,5751,57 13,1713,17
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Deceased donor
allograft 21/Feb/11
AA BB DRDR
RecipientRecipient 2,242,24 35,6535,65 13,1613,16
DonorDonor 2, -2, - 51,5751,57 13,1713,17
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Deceased donor
allograft 21/Feb/11
AA BB DRDR
RecipientRecipient 2,242,24 35,6535,65 13,1613,16
DonorDonor 2, -2, - 51,5751,57 13,1713,17
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Deceased donor
allograft 21/Feb/11
AA BB DRDR
RecipientRecipient 2,242,24 35,6535,65 13,1613,16
DonorDonor 2, -2, - 51,5751,57 13,1713,17
DQ2
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Deceased donor
allograft 21/Feb/11
CDC Cross-match (-)
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Deceased donor
allograft 21/Feb/11
CDC Cross-match (-)
Flow Cross-match (+)
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Deceased donor
allograft 21/Feb/11
CDC Cross-match (-)
Flow Cross-match (+)
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Deceased donor
allograft 21/Feb/11
Cold ischemia – 32 h
Anastomosis time – 40 min.
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G.C.V.J., 49-year-old Brazilian, Caucasian female
Case presentation
Deceased donor
allograft 21/Feb/11
ImmunosuppressionThymo (1,5mg/kg) Tac MMF Prednisone PP/ivig
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sCr
(mg/dL)
(days)
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female(Tac + MMF + Pred)
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(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
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sCr
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Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD
(Tac + MMF + Pred)
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sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD
PP/IVIG3x/week
(Tac + MMF + Pred)
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sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD
(Tac + MMF + Pred)
PP/IVIG3x/week
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sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
(Tac + MMF + Pred)
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sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
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sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
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sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
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B*5714/02/11MFI=5034 28/02/11
MFI=2465
11/03/11MFI=8694
14/02/11MFI=2434
28/02/11MFI=2549
11/03/11MFI=12093DQ*2
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B*5714/02/11MFI=5034 28/02/11
MFI=2465
11/03/11MFI=8694
14/02/11MFI=2434
28/02/11MFI=2549
11/03/11MFI=12093DQ*2
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sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
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0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
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0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
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sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
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10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
![Page 65: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/65.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
![Page 66: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/66.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
![Page 67: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/67.jpg)
B*5714/02/11MFI=5034 28/02/11
MFI=2465
11/03/11MFI=8694
14/02/11MFI=2434
28/02/11MFI=2549
11/03/11MFI=12093DQ*2
![Page 68: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/68.jpg)
B*5714/02/11MFI=5034 28/02/11
MFI=2465
11/03/11MFI=8694
14/02/11MFI=2434
28/02/11MFI=2549
11/03/11MFI=12093DQ*2
![Page 69: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/69.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
graft biopsy
![Page 70: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/70.jpg)
![Page 71: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/71.jpg)
![Page 72: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/72.jpg)
![Page 73: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/73.jpg)
![Page 74: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/74.jpg)
![Page 75: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/75.jpg)
![Page 76: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/76.jpg)
![Page 77: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/77.jpg)
![Page 78: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/78.jpg)
![Page 79: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/79.jpg)
C4d+
![Page 80: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/80.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
![Page 81: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/81.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
Tac dose (blood levels 13 ng/ml)
![Page 82: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/82.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
bortezomib 1st
![Page 83: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/83.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
![Page 84: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/84.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
![Page 85: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/85.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
Tac dose (blood levels 16.3 ng/ml)
![Page 86: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/86.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
bortezomib 2nd
![Page 87: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/87.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
![Page 88: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/88.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
![Page 89: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/89.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
bortezomib 3rd
![Page 90: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/90.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
![Page 91: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/91.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
![Page 92: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/92.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
bortezomib 4th
![Page 93: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/93.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
![Page 94: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/94.jpg)
B*5714/02/11MFI=5034
28/02/11MFI=2465
11/03/11MFI=8694
DQ*2
14/02/11MFI=2434
28/02/11MFI=2549
11/03/11MFI=12093
21/03/11MFI=5998
21/03/11MFI=4218
![Page 95: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/95.jpg)
B*5714/02/11MFI=5034
28/02/11MFI=2465
11/03/11MFI=8694
DQ*2
14/02/11MFI=2434
28/02/11MFI=2549
11/03/11MFI=12093
21/03/11MFI=5998
21/03/11MFI=4218
![Page 96: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/96.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
![Page 97: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/97.jpg)
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728
sCr
(mg/dL)
(days)
Thymoglobuline
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female
HD HD
PP/IVIG3x/week
PP/IVIG3x/week
(Tac + MMF + Pred)
DISCHARGED
DISCHARGED
![Page 98: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/98.jpg)
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5 6 7 8 9 10 11 12
sCr
(mg/dL)
(mo)
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female(Tac + MMF + Pred)
![Page 99: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/99.jpg)
B*57 DQ*2
14/02/11MFI=5034
28/02/11MFI=2465
11/03/11MFI=8694
21/03/11MFI=5998 31/03/11
MFI=553214/02/11MFI=2434
28/02/11MFI=2549
11/03/11MFI=12093
21/03/11MFI=4218
31/03/11MFI=2188
20/04/11MFI=4640
20/04/11MFI=2141
![Page 100: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/100.jpg)
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5 6 7 8 9 10 11 12
sCr
(mg/dL)
(mo)
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female(Tac + MMF + Pred)
![Page 101: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/101.jpg)
14/02/11MFI=5034
28/02/11MFI=2465
11/03/11MFI=8694
21/03/11MFI=5998
31/03/11MFI=5532
20/04/11MFI=4640
05/05/11MFI=3435
14/02/11MFI=2434
28/02/11MFI=2549
11/03/11MFI=12093
21/03/11MFI=4218
31/03/11MFI=2188
20/04/11MFI=2141
05/05/11MFI=1322
23/05/11MFI=3013
23/05/11MFI=6038
B*57 DQ*2
![Page 102: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/102.jpg)
14/02/11MFI=5034
28/02/11MFI=2465
11/03/11MFI=8694
21/03/11MFI=5998
31/03/11MFI=5532
20/04/11MFI=4640
05/05/11MFI=3435
14/02/11MFI=2434
28/02/11MFI=2549
11/03/11MFI=12093
21/03/11MFI=4218
31/03/11MFI=2188
20/04/11MFI=2141
05/05/11MFI=1322
23/05/11MFI=3013
23/05/11MFI=6038
B*57 DQ*2
![Page 103: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/103.jpg)
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5 6 7 8 9 10 11 12
sCr
(mg/dL)
(mo)
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female(Tac + MMF + Pred)
![Page 104: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/104.jpg)
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5 6 7 8 9 10 11 12
sCr
(mg/dL)
(mo)
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female(Tac + MMF + Pred)
APN
![Page 105: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/105.jpg)
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5 6 7 8 9 10 11 12
sCr
(mg/dL)
(mo)
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female(Tac + MMF + Pred)
APN - Cefepime
![Page 106: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/106.jpg)
14/02/11MFI=5034
28/02/11MFI=2465
11/03/11MFI=8694
21/03/11MFI=5998
31/03/11MFI=5532
20/04/11MFI=4640
05/05/11MFI=3435
23/05/11MFI=6038
04/08/11MFI=2045
14/02/11MFI=2434
28/02/11MFI=2549
11/03/11MFI=12093
21/03/11MFI=4218
31/03/11MFI=2188
20/04/11MFI=2141
05/05/11MFI=1322
23/05/11MFI=3013
04/08/11MFI=1457
DQ*2B*57
![Page 107: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/107.jpg)
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5 6 7 8 9 10 11 12
sCr
(mg/dL)
(mo)
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female(Tac + MMF + Pred)
![Page 108: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/108.jpg)
![Page 109: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/109.jpg)
![Page 110: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/110.jpg)
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5 6 7 8 9 10 11 12
sCr
(mg/dL)
(mo)
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female(Tac + MMF + Pred)
![Page 111: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/111.jpg)
![Page 112: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/112.jpg)
![Page 113: 16h30DAVIDSAITOVITCH](https://reader035.vdocuments.us/reader035/viewer/2022062309/568154f3550346895dc2e611/html5/thumbnails/113.jpg)
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5 6 7 8 9 10 11 12
sCr
(mg/dL)
(mo)
Case presentation
G.C.V.J., 49-year-old Brazilian, Caucasian female(Tac + MMF + Pred)
Acknowledgements to Acknowledgements to Dr. Jorge M. Neumann et al.Laboratorio de Imunologia de Transplantes – Hospital Don Vicente Scherer