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dc.contributor.advisorMolina Castaño, Carlos Federico 
dc.creatorRodriguez Rozo, Jorge Enrique 
dc.date.accessioned2016-10-21T13:14:30Z
dc.date.available2016-10-21T13:14:30Z
dc.date.created2016-09-20
dc.date.issued2016 
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/12441
dc.descriptionAntecedentes: 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.
dc.description.abstractBackground: 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.
dc.format.mimetypeapplication/pdf
dc.language.isospa
dc.sourceinstname:Universidad del Rosario
dc.sourcereponame:Repositorio Institucional EdocUR
dc.subjecttrasplante renal
dc.subjectrechazo mediado por anticuerpos
dc.subjectInmunosupresión
dc.subjectRechazo de trasplante
dc.subject.ddcIncidencia & prevención de la enfermedad 
dc.subject.lembEpidemiología
dc.titleTratamiento del rechazo mediado por anticuerpos en pacientes trasplantados renales revisión sistemática
dc.typemasterThesis
dc.publisherUniversidad del Rosario
dc.creator.degreeMagíster en Epidemiología
dc.publisher.programMaestría en Epidemiología
dc.publisher.departmentFacultad de medicina
dc.subject.keywordkidney transplantation
dc.subject.keywordantibody mediated rejection
dc.subject.keywordgraft rejection
dc.subject.keywordgraft survival
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.subject.decsEpidemiología
dc.subject.decsEnfermedades renales
dc.subject.decsInmunología del trasplante
dc.type.spaTesis de maestría
dc.rights.accesoAbierto (Texto completo)
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
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dc.rights.licenciaEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.


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