The effect of combination therapy with rituximab and intravenous immunoglobulin on the progression of chronic antibody mediated rejection in renal transplant recipients.
The effect of combination therapy with rituximab and intravenous immunoglobulin on the progression of chronic antibody mediated rejection in renal transplant recipients.
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DOI：
10.1155/2014/828732
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发表时间：
2014
影响因子：
4.1
通讯作者：
Yang CW
中科院分区：
文献类型：
--
作者：
An GH;Yun J;Hong YA;Khvan M;Chung BH;Choi BS;Park CW;Choi YJ;Kim YS;Yang CW
慢性活性抗体介导的排斥反应（CAMR）的治疗仍然存在争议。我们研究了利妥昔单抗（RTX）和静脉注射免疫球蛋白（IVIg）治疗CAMR的疗效。18例CAMR患者用RTX （375 mg/m2）和IVIg （0.4 g/kg）治疗4天。RTX/IVIg联合治疗（RIT）的疗效通过RIT前后每月肾小球滤过率（ΔeGFR）的下降来评估。根据ΔeGFR降低和不降低的情况将患者分为有反应组和无反应组，比较两组患者的临床和组织学特征。RIT有效率为66.7%(12/18)，总体ΔeGFR在RIT 6个月后显著下降至0.4±1.7 mL·min - 1·1.73 m - 2/月（1.8±1.0,P < 0.05）。12名有反应者和6名无反应者的临床和组织学特征无显著差异，但无反应者在RIT时的蛋白尿水平明显较高（2.5±2.5 vs 7.0±3.5蛋白/肌酐（g/g）， P < 0.001）。RIT对ΔeGFR的影响在RIT后1年内在所有患者中消失。因此，RIT延缓了CAMR的进展，基线蛋白尿水平是RIT反应的预后因素。
The treatment for chronic active antibody-mediated rejection (CAMR) remains controversial. We investigated the efficacy of rituximab (RTX) and intravenous immunoglobulin (IVIg) for CAMR. Eighteen patients with CAMR were treated with RTX (375 mg/m2) and IVIg (0.4 g/kg) for 4 days. The efficacy of RTX/IVIg combination therapy (RIT) was assessed by decline in estimated glomerular filtration rate per month (ΔeGFR) before and after RIT. Patients were divided into responder and nonresponder groups based on decrease and no decrease in ΔeGFR, respectively, and their clinical and histological characteristics were compared. Response rate to RIT was 66.7% (12/18), and overall ΔeGFR decreased significantly to 0.4 ± 1.7 mL·min−1 ·1.73 m−2 per month 6 months after RIT compared to that observed 6 months before RIT (1.8 ± 1.0, P < 0.05). Clinical and histological features between the 12 responders and the 6 nonresponders were not significantly different, but nonresponders had a significantly higher proteinuria levels at the time of RIT (2.5 ± 2.5 versus 7.0 ± 3.5 protein/creatinine (g/g), P < 0.001). The effect of the RIT on ΔeGFR had dissipated in all patients by 1 year post-RIT. Thus, RIT delayed CAMR progression, and baseline proteinuria level was a prognostic factor for response to RIT.
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影响因子：
8.8
作者：
Einecke, G.;Sis, B.;Halloran, P. F.
通讯作者：
Halloran, P. F.
影响因子：
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作者：
Billing, Heiko;Rieger, Susanne;Toenshoff, Burkhard
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Toenshoff, Burkhard
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作者：
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Van Lente, Frederick
影响因子：
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通讯作者：
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