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Acute renal transplant injury and interaction between antithymocyte globulin and pooled human immunoglobulin
Author(s) -
Gallay Brian J,
Perez Richard V,
Ramsamooj Rajen
Publication year - 2004
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2004.00147.x
Subject(s) - medicine , renal transplant , globulin , antibody , immunology , immunoglobulin g , transplantation
The increasing number of highly sensitized patients awaiting renal transplantation has prompted the use of induction immunosuppression regimens including pooled human intravenous immunoglobulin (IVIG) combined with polyclonal anti‐lymphocyte sera. We report a case of a patient who received a live donor transplant after abrogation of donor‐specific positive cytotoxic crossmatch by IVIG. She developed early acute tubular injury associated with IVIG, mannitol, and hypertonic saline infusion. Furthermore, a possible interaction between IVIG and rabbit antithymocyte globulin (ATG) occurred, suggested by an increased number of peripheral CD3 + lymphocytes after initial rapid lymphodepletion. We suggest that IVIG‐associated nephrotoxicity should be considered in the differential diagnosis of early allograft dysfunction, and furthermore, that IVIG may interact with polyclonal antilymphocyte serum to affect the amount of lymphodepletion achieved.