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Pulmonary Capillaritis as a Manifestation of Acute Humoral Allograft Rejection Following Infant Lung Transplantation
Author(s) -
Astor T. L.,
Galantowicz M.,
Phillips A.,
Palafox J.,
Baker P.
Publication year - 2009
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2008.02467.x
Subject(s) - medicine , rituximab , lung , lung transplantation , transplantation , pathology , monoclonal antibody , immunology , antibody , surgery
Pulmonary capillaritis has been described in adult lung transplant recipients, but has not been previously reported in pediatric recipients. We report a case of posttransplant pulmonary capillaritis in an 8‐month‐old infant, and demonstrate evidence of C4d deposition and B‐lymphocytes in the allograft, donor anti‐HLA antibodies in the serum and a clinical and immunohistochemical response to anti‐CD20 monoclonal antibody (rituximab) therapy. These findings strongly support the hypothesis that pulmonary capillaritis may represent a form of acute humoral rejection in the lung allograft that is less common than, and clinically and histologically distinct from, typical acute cellular rejection.