During a routine quarterly check up with my nephrologist three weeks ago, my Urinalysis, and UPC(Urine-Protein Clearance) Ratio test results indicated proteinuria. That’s the presence of abnormal amounts of protein in urine. An indication that my transplanted kidney is not optimally filtering protein. An allograft biopsy was ordered to look closer into the abnormality. This entailed three nights in hospital. The results came after a week, and as feared, one particular finding needed to be addressed immediately.
Borderline Changes Suspicious for Acute T-Cell-Mediated Rejection, or in simpler terms, Acute Allograft Rejection. For one, or several factors, my immune system has started to attack my transplanted kidney, and has already done some damage.
As background, I was diagnosed with End Stage Renal Disease in 2013 and underwent Hemodialysis for around five months. During those five months, my wife Ninette came forward as a donor, got tested and approved. We then went through a strict living, non-related transplant process that resulted in a successful transplant, and this second life I have.
I checked in to hospital the same day I saw my neph with the biopsy results. Treatment was to be immediate to counteract the allograft rejection. What followed were three days of steroid pulsing therapy. Medically termed as Pulse IV Methylprednisolone Therapy, it is the intermittent administration of supraphysiological quantities of the drug to enhance its therapeutic effects while reducing its toxic effects.
There was nothing to it really; nurses would come at 6:00AM, let the IV flow for around 90 minutes, and that was it. The rest of the day was spent doing nothing; Netflix, GoT Reviews, emails, reading, and waiting for the next hospital food service. My doctors were very careful making sure the proteinuria was gone, and creatinine levels have normalized. I spent six days in the National Kidney and Transplant Institute this time around.
I am prone to infections since my immune system was reduced to zero, and ordered to stay home for at least a month except for weekly checkups. I’m hoping I am already at the other end of this rejection episode, and like the doctors, am positive will recover fully.
Section of kidney exhibiting no significant inflammatory cellular infiltrate.
From: Feduska, Nicholas J. et al. “Reversal of renal allograft rejection with intravenous methylprednisolone "pulse" therapy.” The Journal of surgical research 12 3 (1972): 208-15.
