El trasplante renal es el tratamiento sustitutivo de elección en todo el mundo, para pacientes con insuficiencia renal crónica terminal. Históricamente sus comienzos se sitúan a principios del siglo XX en Europa. Su éxito y permanencia como tratamiento electivo hasta ahora es la consecuencia principalmente de los adelantos de las técnicas quirúrgicas, del conocimiento de los fenómenos inmunológicos que se relacionan con la colocación de injertos y del descubrimiento de nuevas drogas inmunosupresoras, ya de uso corriente, como lo es la Ciclosporina A, que tiene gran efectividad en controlar los fenómenos de rechazo. La mejoría en la supervivencia de los injertos ha motivado también el desarrollo de una activa clínica de trasplante renal para encarar las alteraciones del funcionamiento de los injertos, cuyo diagnóstico definitivo descansa en el estudio morfológico de la biopsia renal, que se considera el estándar de oro y cuyos hallazgos histopatológicos fundamentales se muestran en la presente revisión.

Renal transplantation is the substitutive treatment of choice everywhere for patients with terminal chronic renal failure. Historically kidney transplantation was inicially performed in Europe since the beninning of the twenty century and its success and permanence until now as a chosen treatment is the consequence of the continuing advances of the surgical techniques, of the progressive knowledge in the immunological mechanisms involved in grafting and of the discovering of new immunosupressive drugs, such as Cyclosporine A, of current use and very effective to control the rejection reaction. Improvement in kidney graft survival brought about also the development of active clinical programs to face the problems related to the wide scope of graft disfunction, mainly supported by the morphological findings of the renal biopsy, wihch is considered as the gold standard for the diagnosis of disfunction. Some examples of biopsy findings are shown in this review.

In this study, we evaluated the immune response of patients suffering from cutaneous leishmaniasis treated with two distinct protocols. One group was treated with conventional chemotherapy using pentavalent antimonium salts and the other with immunochemotherapy where a vaccine against cutaneous leishmaniasis was combined with the antimonium salt. Our results show that, although no differences were observed in the necessary time for complete healing of the lesions between the two treatments, peripheral blood mononuclear cells from patients treated by chemotherapy showed smaller lymphoproliferative responses at the end of the treatment than those from patients in the immunochemotherapy group. Furthermore, IFN-gamma production was also different between the two groups. While cells from patients in the chemotherapy group produced more IFN-gamma at the end of treatment, a significant decrease in this cytokine production was associated with healing in the immunochemotherapy group. In addition, IL-10 production was also less intense in this latter group. Finally, an increase in CD8+ -IFN-gamma producing cells was detected in the chemotherapy group. Together these results point to an alternative treatment protocol where healing can be induced with a decreased production of a potentially toxic cytokine.