Abstract:
BACKGROUND:Chronic active antibody-mediated rejection (CAMR) is an important cause of chronic kidney allograft dysfunction, but there has been no effective treatment protocol established for it. METHODS:Six renal transplant recipients who showed progressive deterioration in graft function and CAMR as diagnosed by biopsy were enrolled. We administered a single dose of rituximab (375 mg/m(2)), followed by intravenous immunoglobulin (IVIg, 0.4 g/kg) for 4 days. The efficacy of this protocol was assessed on the basis of the improvement in allograft function, the amount of proteinuria, and the change in donor-specific antibodies (DSAs). We categorized the patients into 2 groups, responders and nonresponders, according to their response to the treatment. RESULTS:All of the patients showed progressive deterioration of graft function before the diagnosis of CAMR. Luminex solid-phase assays showed that 3 patients had DSAs. After the treatment, allograft function improved or stabilized in 3 patients in the responder group, but still showed a deteriorating pattern in the nonresponder group. In the responder group, the amount of proteinuria also decreased after the treatment, but it increased in the nonresponder group. On diagnosis of CAMR, the nonresponders showed a longer posttransplantation period, a higher degree of transplant glomerulopathy, more severely deteriorated allograft function, and higher proteinuria compared with the responders. CONCLUSIONS:The combination of rituximab and IVIg was effective in early-stage CAMR, but the effect was limited in the advanced stage.
journal_name
Transplant Procjournal_title
Transplantation proceedingsauthors
Hong YA,Kim HG,Choi SR,Sun IO,Park HS,Chung BH,Choi BS,Park CW,Kim YS,Yang CWdoi
10.1016/j.transproceed.2011.12.006subject
Has Abstractpub_date
2012-01-01 00:00:00pages
182-4issue
1eissn
0041-1345issn
1873-2623pii
S0041-1345(11)01668-Xjournal_volume
44pub_type
杂志文章abstract::Measurement of immunosuppressive drug concentrations cyclosporine A (CyA), tacrolimus (TAC), sirolimus (SIR), and everolimus (EVE) in blood is an important application of therapeutic drug monitoring. These immunosuppressive agents are used in combined regimens and nowadays the liquid chromatography and tandem mass spe...
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更新日期:2012-05-01 00:00:00
abstract::Solid organ transplant recipients undergoing immunosuppressive therapy are considered to be at high risk for serious infectious complications. Recently in the United States, a pandemic of H1N1 flu infection has been reported with serious complications. We describe H1N1 infection in a living kidney donor and the 42-yea...
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pub_type: 杂志文章
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更新日期:2009-12-01 00:00:00
abstract::The availability of cadaveric donor organs is insufficient for actual needs. The organ demand increases by 20% per year. Living donor transplant (LDT) may be a valid therapeutical alternative provided one uses proper criteria. LDT provides many advantages, like improved patient and organ survival, short waiting time, ...
journal_title:Transplantation proceedings
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更新日期:2004-04-01 00:00:00
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journal_title:Transplantation proceedings
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更新日期:2014-04-01 00:00:00
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journal_title:Transplantation proceedings
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更新日期:2015-05-01 00:00:00
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更新日期:2015-05-01 00:00:00
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journal_title:Transplantation proceedings
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journal_title:Transplantation proceedings
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更新日期:2010-05-01 00:00:00
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更新日期:2018-12-01 00:00:00
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更新日期:2019-01-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.06.113
更新日期:2008-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.transproceed.2010.02.073
更新日期:2010-06-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.11.005
更新日期:2013-03-01 00:00:00
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更新日期:2009-07-01 00:00:00
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journal_title:Transplantation proceedings
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更新日期:2009-11-01 00:00:00
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doi:10.1016/j.transproceed.2006.02.093
更新日期:2006-06-01 00:00:00
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更新日期:2012-11-01 00:00:00
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更新日期:2007-09-01 00:00:00
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