Acute antibody-mediated rejection after ABO-incompatible kidney transplantation treated successfully with antigen-specific immunoadsorption

SA Just, N Marcussen, U Sprogøe… - Nephrology Dialysis …, 2010 - academic.oup.com
SA Just, N Marcussen, U Sprogøe, P Koefoed-Nielsen, C Bistrup
Nephrology Dialysis Transplantation, 2010academic.oup.com
ABO-incompatible kidney transplantation is possible after pre-treatment with rituximab,
intravenous immunoglobulin and basiliximab combined with tacrolimus, mycophenolate
mofetil and prednisolone. We report on the first patient treated with this protocol who
developed acute antibody-mediated rejection (Banff grade II with IgG deposits) caused by
ABO antibodies (anti-B). Anti-rejection treatment with anti-B-specific immunoadsorption,
intravenous immunoglobulin and methylprednisolone efficiently cleared deposited IgG from …
Abstract
ABO-incompatible kidney transplantation is possible after pre-treatment with rituximab, intravenous immunoglobulin and basiliximab combined with tacrolimus, mycophenolate mofetil and prednisolone. We report on the first patient treated with this protocol who developed acute antibody-mediated rejection (Banff grade II with IgG deposits) caused by ABO antibodies (anti-B). Anti-rejection treatment with anti-B-specific immunoadsorption, intravenous immunoglobulin and methylprednisolone efficiently cleared deposited IgG from the kidney allograft and re-established normal kidney function. We suggest that ABO-incompatible kidney transplantation complicated by acute antibody-mediated rejection, caused by ABO antibodies, may successfully be treated with this regime.
Oxford University Press