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Case 1 | Case 2 |
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1-Haplotype-match | 2-Haplotypes match |
Induction therapy with Basiliximab | No induction therapy |
21 days posttransplantation | 1 month posttransplantation |
Gross hematuria and dysuria | Severe dysuria |
No fever (36.7°C) | Fever (38°C) |
Urine analysis with 49 leukocytes and 135 erythrocytes per each high-power field. | Urine analysis with 6 leukocytes and 4 bacteria per each high-power field. |
Hb 11 g/dL, leukocytes 5.8 K/uL, and platelets 238 K/uL. | Hb 13.9 g/dL, leukocytes 5.7 K/uL, and platelets 265 K/uL. |
Renal ultrasound with moderate hydronephrosis, normal blood flow. | Renal ultrasound with increase in size and echogenicity, data suggesting hypoperfusion. |
Normal graft biopsy | Graft biopsy with histopathological changes and (+) real-time PCR for adenovirus |
Blood and urine real-time PCR (+) for adenovirus; CMV and BK virus serology (−) | Blood and urine real-time PCR (+) for adenovirus; CMV and BK virus serology (−) |
TAC dose reduced, MMF suspended | TAC dose reduced, MMF suspended |
Treatment with ribavirin and IVIG | Treatment with IVIG only |
SCr returned to basal level (1.3 mg/dL) after treatment. | SCr remained elevated (1.6 mg/dL) but with a recent tendency to decrease (1.4 mg/dL). Control graft biopsy with <2% fibrosis. Control graft biopsy with <2% fibrosis. |
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