A case of long-term tolerance after kidney transplantation

We present a case of long-term organ functioning (ca.10 years) after allografting cadaveric kidney without usage immunosuppressing drugs. In 2005, patient suffering from hypertensive form chronic glomerulonephritis, have received an allogeneic graft compatible for AB0 system, HLA antigens (A19, B07, DR04), and negative results cross-match test. The function was immediately restored, with normalization creatinine levels achieved 4-5 days surgery. Immunosuppression cyclosporine, solumedrol, cellсept, metypred simulect performed in the hospital. Pulse therapy solumedrol on day +20 due to development initial rejection signs. postoperative period proceeded infectious complications. discharged being recommended take Cell-Sept Metypred. Within year transplantation, claimed pain hip joint, and, therefore, completely canceled. Subsequently, Cellcept replaced Mayfortic. 2007, signs coxarthrosis were revealed at computed tomography, followed by aseptic necrosis right femur head. Deforming osteoarthritis joint detected, replacement surgery suggested. 2010, risk side effects ongoing immunosuppressive therapy, e.g., damage, Mayfortic 2012, fear original Sandimmun Neoral generic drug, refused cyclosporine therapy. 2021, endoprosthetics performed, surgical wound healed initially. Since has not taken Over this time period, never been admitted hospital impaired graft. Meanwhile, he monitored his regular basis undergoing biochemical analyses, clinical examination, ultrasound studies made visits outpatient department. week replacement, there slight increase serum creatinine, further 230 mmol/L 310 March 2022. February 2022, suffered mild respiratory infection (confirmed COVID-19). first increasing nephropathy appeared, i.e., swelling both lower extremities, leukocytes urine upon routine analysis, increased blood flow resistance main artery transplant shown study. Due worsening patient’s condition, resumed taking prescribed immunosuppressants.