dr. Besut Daryanto, SpB, SpU (K)HEAD OF UROLOGIST DEPARTEMENTSAIFUL ANWAR HOSPITAL- MALANG

A kidney transplant is an operation in which a person whose own kidneys have failed receives a new kidney to take over the work of cleaning their blood. (National Kidney Foundation,2006)

There is 7 patients already done with renal transplantation at RSSA Malang since 2012 until now.Recipient got a kidney organ from living donors.

RESIPIENThe youngest : 15 yoThe oldest : 52 yo

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PatientCKD(Chronic Kidney Disease)HT(Hypertension)DM(Diabetes Mellitus)Lung TBHistory of CMV (cytome galovirus)1+ (6 months)+ (7 years)+ (12 years)-Anti CMV igG +2+ (5 months)+ (6 years)-+ ( 3 years)Anti CMV igG +

3+ (1 years)+ ( 2 years)--Anti CMV igG +

4+ (2 years)+ ( 2 years)-Anti CMV igG +

5+ (1 year)+ (1 year)--Anti CMV igG +

6+ (2 years)+ (3 years)+ (28 years)-Anti CMV igG +

7+ ( 3 months)+ (3 months)--Anti CMV igG +

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Second transplantation : 1 patient ( China, 8 years ago)

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PatientHemodialisis CAPDAnother12 time/weeks, since 6 month ago-DM on insulin, Hypertension on therapy since 7 years ago, lisinopril 10 mg22 time/weeks, since 5 month ago-Hypertension got tx tensivask 10 mg. Lung TB on OAT start at Okt 28 th 2012, with remactan 450 mg and babuctinh32 time per weeks, since 3 month ago-Hipertension on treatment History renal transplant 9 years ago because CKD4-since 3 month HT on treatment52 times/week, since 1 years ago-At June 16th 2010 had nephrolithiasis operation, stone shape : Staghorn, with Analyzed of stone : 55% uric acid and 45% oxalate acid 6-1.5 years ago, decrease of renal functionsince last 8 monthDM uncontrolled72-3 times/week, since 3 months ago-Hypertension on tx with amlodipin and furosemid

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New diagnostic prosedure.Flow cytometric crossmatching (FCXM) and screening techniques are sensitive techniques at detecting anti-HLA antibodies. (J Am Soc Nephrol 12: 28072814, 2001)

Measurement of numerous cell properties (cytometry) as the cells move in single file (flow) in a fluid column and interrupt a beam of laser light.Quantitative and qualitative analysis of several (multiparameter) of cell populations from body fluids.

T CELL REACTIONB CELL REACTIONSPECIFICITYNEGATIVENEGATIVENONEPOSITIVEPOSITIVEHLA CLASS I + IINEGATIVEPOSITIVEHLA CLASS II?LOW TITER CLASS INon-HLA ANTIBODY?POSITIVENEGATIVE

Flow cytometric enhancement ofSensitivitySpecivityDetection of low titer HLA antibodiesIdentification of IgM class autoantibodiesDetection of non cytotoxic HLA antibodiesElimination of reactions attributed to immune complexesDetection of B cell specific class II antibodiesDistinction of clinically insignificant IgG class antibodies

The last resipien for transplant operation had screening by HLA and flowcytometryFlowcytometry is a new diagnostic procedure for detecting anti-HLA antibodies.Successful kidney transplant give a better quality of life for the patient compared with haemodyalisis and CAPD.

MANUAL PROCEDUR AFTER RENAL TRANSPLANTATION