Successful rescue and maintenance of long‐term remission of anti‐HLA antibody‐mediated acute allograft rejection by rituximab‐containing therapy: case report

DOI

Search this article

Description

<jats:p><jats:bold>Abstract: </jats:bold> A 38‐yr‐old man with chronic renal failure received a second kidney transplantation from a cadaveric donor. Complement‐dependent cytotoxicity cross‐match (CDC) was negative against T cells, but positive with the B‐cell warm test. Human leukocyte antigen (HLA)‐typing showed a one haplo‐identical match. The blood type was compatible. He was treated with tacrolimus, mycophenolate mofetil (MMF), methylpredonisolone (MP), and basiliximab as immunosuppressive therapy. A clinical episode graft biopsy and Flow‐PRA on post‐operative day (POD) 19 showed anti‐HLA antibody‐mediated acute rejection (AHR). The patient was treated with plasmapheresis (PP). Renal biopsy performed on POD 65 because of re‐rise of serum creatinine level showed worsening of renal injury. The patient was treated with rituximab (100 mg/body) with PP and MP pulse therapy, followed by tacrolimus and MMF. Graft function thereafter improved. A renal allograft biopsy specimen on POD 300 and Flow‐PRA showed the remission of AHR within one‐yr after transplantation.</jats:p>

Journal

Details 詳細情報について

Report a problem

Back to top