Open AccessRituximab Therapy for Acute Humoral Rejection After Kidney Transplantation
Author(s) -
Stanislas Faguer,
Nassim Kamar,
Céline Guilbeaud-Frugier,
Marylise Fort,
Anne Modesto,
Arnaud Mari,
David Ribes,
Olivier Cointault,
Laurence Lavayssière,
Joëlle Guitard,
Dominique Durand,
Lionel Rostaing
Publication year - 2007
Publication title -
transplantation
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 1.45
H-Index - 204
eISSN - 1534-6080
pISSN - 0041-1337
DOI - 10.1097/01.tp.0000261113.30757.d1
Subject(s) - rituximab , medicine , tacrolimus , creatinine , transplantation , renal function , kidney transplantation , urology , mycophenolate , kidney , gastroenterology , nephrology , mycophenolic acid , immunology , surgery , antibody
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 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 micromol/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.