dr.

Besut Daryanto, SpB, SpU (K)

HEAD OF UROLOGIST DEPARTEMENT
SAIFUL 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.

RESIPIEN
The youngest : 15 yo
The oldest
: 52 yo

Patient

CKD
(Chronic Kidney
Disease)

HT
(Hypertension)

DM
(Diabetes
Mellitus)

+ (12 years)

Lung TB

History of
CMV
(cytome
galovirus)

Anti CMV igG

+

+ (6 months)

+ (7 years)

+ (5 months)

+ (6 years)

+ ( 3 years)

Anti CMV igG

+

+ (1 years)

+ ( 2 years)

Anti CMV igG

+

+ (2 years)

+ ( 2 years)

Anti CMV igG

+

+ (1 year)

+ (1 year)

Anti CMV igG

+

+ (2 years)

+ (3 years)

Anti CMV igG

+

+ ( 3 months)

+ (3 months)

Anti CMV igG

+

+ (28 years)
-

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

Patient

Hemodialisis

CAPD

Another

2 time/weeks, since 6 month ago

DM on insulin, Hypertension on
therapy since 7 years ago, lisinopril 10
mg

2 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
babuctinh

2 time per weeks, since 3 month ago

Hipertension on treatment
History renal transplant 9 years ago
because CKD

since 3 month

HT on treatment

2 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

1.5 years ago, decrease of

renal functionsince last 8
month

DM uncontrolled

2-3 times/week, since 3 months ago

Hypertension on tx with amlodipin and

furosemid

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 REACTION

B CELL
REACTION

SPECIFICITY

NEGATIVE

NEGATIVE

NONE

POSITIVE

POSITIVE

HLA CLASS I + II

NEGATIVE

POSITIVE

POSITIVE

NEGATIVE

HLA CLASS II?

LOW TITER CLASS I
Non-HLA ANTIBODY?

Flow cytometric enhancement of

Sensitivity

Specivity

Detection of low titer HLA antibodies

Identification of IgM class

autoantibodies

Detection of non cytotoxic HLA

antibodies

Elimination of reactions attributed to

immune complexes

Detection of B cell specific class II

antibodies

Distinction of clinically insignificant IgG

class antibodies

The last resipien for transplant operation had

screening by HLA and flowcytometry
Flowcytometry 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