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Successful rescue of late‐onset acute T‐cell mediated rejection with anti‐CD25 antibody: a case report
Author(s) -
Osawa Takahiro,
Harada Hiroshi,
Miura Masayoshi,
Ogawa Yayoi,
Morooka Kanako,
Nakamura Michiko,
Tanabe Tatsu,
Takada Norikata,
Seki Toshimori,
Togashi Masaki,
Takenouchi Toshinao,
Hirano Tetsuo
Publication year - 2009
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.1399-0012.2009.01006.x
Subject(s) - medicine , antibody , immunology
A 56‐yr‐old Japanese male with a history of diabetic nephropathy underwent a HLA 5/6 mismatch and ABO‐compatible living‐related kidney transplantation (donor: his 49‐yr‐old wife). A pre‐transplant standard NIH complement‐dependent cytotoxicity cross‐match (Xm) test, a flow‐cytometric T‐cell Xm, and a FlowPRA™ test were totally negative. Inductionimmunosuppressive protocol consisted of tacrolimus, mycophenolate mofetil, methylprednisolone, and basiliximab (BAS). The patient’s post‐operative course was almost uneventful, and the graft was functioning well (sCr 1.1 mg/dL). He developed general fatigue, and his sCr was elevated to 2.2 mg/dL 792 d after transplant. A graft biopsy showed acute T‐cell mediated rejection Banff grade IB (i3, t3, g0, v0, ptc0, C4d staining negative). The conventional anti‐rejection therapy could not improve his graft function; therefore, we added BAS to eliminate activated graft‐infiltrating T‐cells. He responded to the rescue therapy, and the improvement in graft function was confirmed by a subsequent graft biopsy. He enjoyed his health without any opportunistic infections.