Rituximab therapy for acute humoral rejection after kidney transplantation
Rituximab therapy for acute humoral rejection after kidney transplantation
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DOI：
10.1097/01.tp.0000261113.30757.d1
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发表时间：
2007-05-15
期刊：
影响因子：
6.2
通讯作者：
Rostaing, Lionel
中科院分区：
文献类型：
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作者：
Faguer, Stanislas;Kamar, Nassim;Rostaing, Lionel
一项初步研究对8名出现急性体液性排斥反应（AHR）的连续肾移植（RT）患者进行了评估，以评估单克隆抗b细胞抗体的疗效，如利妥昔单抗（每周375 mg/m(2)），连续3至5周，此外还有血浆置换（PE）、类固醇、霉酚酸酯和他克莫司。AHR与血清肌酐升高、供体特异性同种异体抗体（DSA）的出现以及移植活检中C4d的存在有关。随访10个月（7-23个月）后，患者和移植物的存活率分别为100%和75%。6例患者肾功能改善，血清肌酐由297 +/- 140降至156 +/- 53 μ mol/L (P=0.015)；2例发生移植物丢失；4名患者有感染并发症。最后随访4例，DSA消失或降低。除了PE外，利妥昔单抗治疗可能对出现AHR的RT患者有益。
A pilot study was performed on eight consecutive renal-transplant (RT) patients presenting with acute humoral rejection (AHR) to assess the efficacy of monoclonal anti-B cell antibodies, such as rituximab (375 mg/m(2) weekly) for 3 to 5 consecutive weeks, in addition to plasma exchange (PE), steroids, mycophenolate mofetil, and tacrolimus. AHR was associated with increased serum creatinine, the appearance of donor-specific alloantibodies (DSA), and the presence of C4d in a transplant biopsy. After a follow-up of 10 months (range 7-23), patient and graft survivals were 100% and 75%, respectively. Renal function improved in six cases in which serum creatinine decreased from 297 +/- 140 to 156 +/- 53 mu mol/L (P=0.015); graft loss occurred in two cases; and four patients had infectious complications. At last follow-up, DSA had disappeared or decreased in four cases. Rituximab therapy, in addition to PE, might be of benefit for RT patients presenting with AHR.