Case Scenario: Post transplant monitoring and rejection
Case Study: 45 y/o Female is planning for her first transplant with her husbands 2 haploidentical brother. Her single antigen bead is positive with a single DSA of 5000 and you proceed for transplant after desensitization.
Questions & Answers
Q1. How frequently should KFT and urine testing be performed?
Ans: Personal opinion: at least monthly, after the standard first 3-4 month monitoring.
Q2. How frequently should tac level be tested and tac dose adjusted?
Ans: Till stable frequently or after dose change, then once every 6 months.
Q3. Should we perform additional testing, BK virus, SAB, Cell free DNA and if so, how frequently and how do we utilize the results to guide treatment?
Ans: Personal opinion: would do it before any major immunosuppression change or at times when plan to reduce immunos (tac targets or mmf reduction or a few months after reductions to assess if any activation of immune system has happened
