Tratamiento del rechazo mediado por anticuerpos en pacientes trasplantados renales revisión sistemática
Antecedentes: El trasplante renal es la mejor alternativa terapéutica para la enfermedad renal crónica terminal. Los medicamentos inmunosupresores previenen el rechazo. El rechazo mediado por anticuerpos es frecuente y disminuye la función y duración del injerto. Objetivo: Evaluar sistemáticamente l...
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| Formato: | Tesis de maestría (Master Thesis) |
| Lenguaje: | Español (Spanish) |
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Universidad del Rosario
2016
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| Acceso en línea: | http://repository.urosario.edu.co/handle/10336/12441 |
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EdocUR - Universidad del Rosario |
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Español (Spanish) |
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trasplante renal rechazo mediado por anticuerpos Inmunosupresión Rechazo de trasplante Incidencia & prevención de la enfermedad Epidemiología kidney transplantation antibody mediated rejection graft rejection graft survival Epidemiología Enfermedades renales Inmunología del trasplante |
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trasplante renal rechazo mediado por anticuerpos Inmunosupresión Rechazo de trasplante Incidencia & prevención de la enfermedad Epidemiología kidney transplantation antibody mediated rejection graft rejection graft survival Epidemiología Enfermedades renales Inmunología del trasplante Rodriguez Rozo, Jorge Enrique Tratamiento del rechazo mediado por anticuerpos en pacientes trasplantados renales revisión sistemática |
| description |
Antecedentes: El trasplante renal es la mejor alternativa terapéutica para la enfermedad renal crónica terminal. Los medicamentos inmunosupresores previenen el rechazo. El rechazo mediado por anticuerpos es frecuente y disminuye la función y duración del injerto. Objetivo: Evaluar sistemáticamente la evidencia disponible relacionada con la eficacia y seguridad del tratamiento para el rechazo mediado por anticuerpos en pacientes trasplantados renales. Metodologia: Revisión sistemática en bases de datos MEDLINE, EMBASE, Scopus y Biblioteca virtual de la salud. Literatura gris google scholar, google academico, www.clinicaltrialsregister.eu, and https://clinicaltrials.gov/. Búsqueda manual referencias artículos pre-seleccionados así como de revisiones previamente publicadas. Se siguieron las recomendacioes guia PRISMA para la identificacion de artículos potenciales, tamizaje y selección teniendo en cuenta los criterios de inclusion. Extracción datos de acuerdo a las variables, revisión calidad de los artículos elegidos utilizando evaluación riesgo de segos de Cochrane. Resultados: Se seleccionaron 9 ensayos clínicos publicados entre 1980 y 2016, incluyeron 222 pacientes (113 brazo de intervención y 109 en el control), seguimiento promedio 16 meses. Intervenciones evaluadas plasmaféresis, inmunoadsorción y rituximab. Hubo una amplia heterogeneidad en la definición de criterios de inclusión, criterios diagnósticos de rechazo y medidas de evaluación de eficacia de las intervenciones. Tres estudios encontraron diferencias estadísticamente significativas entre los grupos de tratamiento. Conclusiones: La evidencia sobre la eficacia de los tratamientos del rechazo mediado por anticuerpos en injertos renales es de baja calidad. Son necesarios ensayos clínicos controlados para poder definir el tratamiento óptimo de estos pacientes. |
| author2 |
Molina Castaño, Carlos Federico |
| author_facet |
Molina Castaño, Carlos Federico Rodriguez Rozo, Jorge Enrique |
| format |
Tesis de maestría (Master Thesis) |
| author |
Rodriguez Rozo, Jorge Enrique |
| author_sort |
Rodriguez Rozo, Jorge Enrique |
| title |
Tratamiento del rechazo mediado por anticuerpos en pacientes trasplantados renales revisión sistemática |
| title_short |
Tratamiento del rechazo mediado por anticuerpos en pacientes trasplantados renales revisión sistemática |
| title_full |
Tratamiento del rechazo mediado por anticuerpos en pacientes trasplantados renales revisión sistemática |
| title_fullStr |
Tratamiento del rechazo mediado por anticuerpos en pacientes trasplantados renales revisión sistemática |
| title_full_unstemmed |
Tratamiento del rechazo mediado por anticuerpos en pacientes trasplantados renales revisión sistemática |
| title_sort |
tratamiento del rechazo mediado por anticuerpos en pacientes trasplantados renales revisión sistemática |
| publisher |
Universidad del Rosario |
| publishDate |
2016 |
| url |
http://repository.urosario.edu.co/handle/10336/12441 |
| _version_ |
1645141386820845568 |
| spelling |
ir-10336-124412019-09-19T12:37:54Z Tratamiento del rechazo mediado por anticuerpos en pacientes trasplantados renales revisión sistemática Rodriguez Rozo, Jorge Enrique Molina Castaño, Carlos Federico trasplante renal rechazo mediado por anticuerpos Inmunosupresión Rechazo de trasplante Incidencia & prevención de la enfermedad Epidemiología kidney transplantation antibody mediated rejection graft rejection graft survival Epidemiología Enfermedades renales Inmunología del trasplante Antecedentes: El trasplante renal es la mejor alternativa terapéutica para la enfermedad renal crónica terminal. Los medicamentos inmunosupresores previenen el rechazo. El rechazo mediado por anticuerpos es frecuente y disminuye la función y duración del injerto. Objetivo: Evaluar sistemáticamente la evidencia disponible relacionada con la eficacia y seguridad del tratamiento para el rechazo mediado por anticuerpos en pacientes trasplantados renales. Metodologia: Revisión sistemática en bases de datos MEDLINE, EMBASE, Scopus y Biblioteca virtual de la salud. Literatura gris google scholar, google academico, www.clinicaltrialsregister.eu, and https://clinicaltrials.gov/. Búsqueda manual referencias artículos pre-seleccionados así como de revisiones previamente publicadas. Se siguieron las recomendacioes guia PRISMA para la identificacion de artículos potenciales, tamizaje y selección teniendo en cuenta los criterios de inclusion. Extracción datos de acuerdo a las variables, revisión calidad de los artículos elegidos utilizando evaluación riesgo de segos de Cochrane. Resultados: Se seleccionaron 9 ensayos clínicos publicados entre 1980 y 2016, incluyeron 222 pacientes (113 brazo de intervención y 109 en el control), seguimiento promedio 16 meses. Intervenciones evaluadas plasmaféresis, inmunoadsorción y rituximab. Hubo una amplia heterogeneidad en la definición de criterios de inclusión, criterios diagnósticos de rechazo y medidas de evaluación de eficacia de las intervenciones. Tres estudios encontraron diferencias estadísticamente significativas entre los grupos de tratamiento. Conclusiones: La evidencia sobre la eficacia de los tratamientos del rechazo mediado por anticuerpos en injertos renales es de baja calidad. Son necesarios ensayos clínicos controlados para poder definir el tratamiento óptimo de estos pacientes. Background: Kidney transplantation is the best therapeutic choice for end-stage chronic kidney disease (ES-CKD). Immunosuppressive drugs prevent rejection. Antibody mediated rejection is a frequent complication and implies a decrease in graft function and duration. This study is a systematic review to evaluate the evidence available regarding antibody mediated rejection treatment efficacy and safety in kidney transplant patients. Methods: Systematic review of databases MEDLINE, EMBASE, Scopus and Health Virtual Library (BVS in spanish). The grey literature sources were: google scholar, google academico, www.clinicaltrialsregister.eu, and https://clinicaltrials.gov/. There was a manual search of the references of every article pre-selected, as well as the review articles published previously. The PRISMA guidelines recommendations for identifying potential items, screening and selection were followed considering the inclusion criteria. Data according to variables were extracted and to asses the quality of the articles selected the evaluation of bias risk by Cochrane was used. Results: Nine clinical trials published 1980 and 2016 were selected, included 222 patients (113 at intervention arm, and 109 as control), with an average follow-up of 16 months. Interventions evaluated were plasmapheresis, immunoadsortion and rituximab. There was a wide heterogeneity in the definition of inclusion criteria, diagnostic criteria for rejection and assessment effectiveness of interventions. Three studies was able to demonstrate a statistical significance between treatment groups. Conclusion: The data describing the efficacy of treatments for antibody-mediated rejection in renal allografts are of low. Larger randomized controlled trials are required in order to define the optimal scheme of treatment for these patients. 2016-09-20 2016-10-21T13:14:30Z info:eu-repo/semantics/masterThesis info:eu-repo/semantics/acceptedVersion http://repository.urosario.edu.co/handle/10336/12441 spa info:eu-repo/semantics/openAccess application/pdf Universidad del Rosario Maestría en Epidemiología Facultad de medicina instname:Universidad del Rosario reponame:Repositorio Institucional EdocUR Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. 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