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Características clínicas de pacientes trasplantados renal y hepático con enfermedades reumáticas autoinmunes en LaCardio entre 2018-2024

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dc.contributor.advisorVargas Nieto, Lina Patricia
dc.contributor.advisorMoreno León, Julian Mauricio
dc.contributor.otherCruz-Cuevas, Jose D.
dc.contributor.otherSanin Reyes, Antonia
dc.contributor.otherZúñiga-Rodríguez, Eduardo
dc.contributor.otherCajamarca-Barón, Jairo
dc.contributor.otherDiaz-Nassif, Gustavo
dc.contributor.otherCastellanos-de la Hoz, Juan
dc.contributor.otherPeña Peña, Adwar
dc.contributor.otherRojas-Villarraga, Adriana
dc.creatorBallesteros García, María Camila
dc.creatorEscobar Montoya, Lina María
dc.creator.degreeEspecialista en Medicina Interna
dc.creator.degreeLevelMaestría
dc.date.accessioned2026-07-15T21:46:16Z
dc.date.available2026-07-15T21:46:16Z
dc.date.created2026-07-14
dc.date.embargoEndinfo:eu-repo/date/embargoEnd/2028-07-16
dc.descriptionIntroducción: La coexistencia de enfermedades reumáticas autoinmunes y trasplante de órgano sólido presenta una interacción compleja que puede afectar tanto la supervivencia del injerto como la calidad de vida del paciente, además de incrementar el riesgo de rechazo, reactivación de la autoinmunidad y complicaciones derivadas de la inmunosupresión. Objetivo: Caracterizar clínica y sociodemográficamente a los pacientes con trasplante renal o hepático que presentan enfermedades reumáticas autoinmunes atendidos en LaCardio entre 2018 y 2024. Métodos: Estudio observacional de corte transversal con componente descriptivo en pacientes mayores de 18 años con enfermedad reumática autoinmune y antecedente de trasplante renal o hepático. Mediante revisión manual y sistemática de historias clínicas, se evaluaron variables asociadas a desenlaces adversos utilizando análisis descriptivos y univariados. Resultados: Se incluyeron 104 pacientes (64,4% hepático, 35,6% renal), predominantemente mujeres (75,0%), con mediana de 40 años (RIQ: 27–57). La prevalencia de rechazo fue 33,3%, principalmente celular, siendo mayor en receptores hepáticos (86,4% vs. 55,6%; p=0,034). La recurrencia de la enfermedad hepática autoinmune en el injerto ocurrió en el 21,5% de los casos, después de los 12 meses del trasplante. Las infecciones en el primer año alcanzaron un 36,0%, lideradas por infección urinaria. La mortalidad global fue del 13,5%, mayor en los receptores de trasplante hepático. Conclusiones: La alta frecuencia de rechazo, recurrencia de enfermedad reumática autoinmune e infecciones reflejan la necesidad de un seguimiento multidisciplinario prolongado y una terapia inmunosupresora individualizada. El estudio aporta evidencia epidemiológica valiosa sobre esta población de alta complejidad en Latinoamérica.
dc.description.abstractIntroduction: The coexistence of autoimmune rheumatic diseases and solid organ transplantation represents a complex clinical scenario that may adversely affect graft outcomes and patient quality of life while increasing the risk of graft rejection, autoimmune disease recurrence, and complications related to immunosuppressive therapy. Objective: To clinically and sociodemographically characterize kidney and liver transplant recipients with autoimmune rheumatic diseases treated at LaCardio between 2018 and 2024. Methods: This observational cross-sectional study included adult patients (≥18 years) with autoimmune rheumatic diseases and a history of kidney or liver transplantation. Data were obtained through a systematic manual review of electronic medical records. Clinical characteristics and post-transplant outcomes were assessed using descriptive and univariate analyses. Results: A total of 104 patients were included, of whom 64.4% underwent liver transplantation and 35.6% kidney transplantation. Most patients were female (75.0%), with a median age of 40 years (IQR, 27–57). The prevalence of graft rejection was 33.3%, predominantly T cell-mediated rejection, and was higher among liver transplant recipients (86.4% vs. 55.6%; p=0.034). Recurrence of autoimmune liver disease in the graft occurred in 21.5% of cases, typically >12 months after transplantation. Infections during the first post-transplant year occurred in 36.0% of patients, with urinary tract infection being the most frequent. Overall mortality was 13.5% and was higher among liver transplant recipients. Conclusion: The high frequency of graft rejection, autoimmune disease recurrence, and post-transplant infections underscores the need for prolonged multidisciplinary follow-up and individualized immunosuppressive strategies. This study provides valuable epidemiological evidence on this complex and understudied patient population in Latin America.
dc.format.extent68 pp
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.48713/10336_48043
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/48043
dc.language.isospa
dc.publisherUniversidad del Rosario
dc.publisher.departmentEscuela de Medicina y Ciencias de la Salud
dc.publisher.programEspecialización en Medicina Interna
dc.rightsAttribution-NonCommercial-ShareAlike 4.0 International*
dc.rights.accesRightsinfo:eu-repo/semantics/embargoedAccess
dc.rights.accesoRestringido (Temporalmente bloqueado)
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dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subjectTrasplante de órganos
dc.subjectEnfermedades autoinmunes
dc.subjectRechazo de injerto
dc.subjectInfecciones
dc.subjectInmunosupresores
dc.subject.keywordOrgan transplantation
dc.subject.keywordAutoimmune diseases
dc.subject.keywordGraft rejection
dc.subject.keywordInfections
dc.subject.keywordImmunosuppressive agents
dc.titleCaracterísticas clínicas de pacientes trasplantados renal y hepático con enfermedades reumáticas autoinmunes en LaCardio entre 2018-2024
dc.title.TranslatedTitleClinical Characteristics of Kidney and Liver Transplant Recipients with Autoimmune Rheumatic Diseases at LaCardio, 2018–2024
dc.title.alternativeEnfermedades reumáticas en trasplante renal y hepático: experiencia en LaCardio
dc.typemasterThesis
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de grado
local.department.reportEscuela de Medicina y Ciencias de la Salud
local.regionesBogotá
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