Treatment of Biopsy-Proven Acute Antibody-Mediated Rejection Using Thymoglobulin (ATG) Monotherapy and a Combination of Rituximab, Intravenous Immunoglobulin, and Plasmapheresis: Lesson Learned from Primary Experience.

CONCLUSIONS: All 5 AMR cases occurred in patients who received renal transplants from HLA highly mismatched DCD donors. Both ATG and rituximab had a significant depleting effect on B cells, but their effects on DSA were not ideal. Mild or moderate acute AMR was ameliorated but not cured by ATG monotherapy. For AMR patient with severe biopsy-proven graft injuries, B cell- and antibody-targeted therapies were not successful since they do not have immediate inhibitory or blocking effects on antibody-caused tissue injury. Therefore, anti-inflammatory, anti-coagulation and complement blockage agents should also be considered as part of an AMR treatment regimen in addition to strategies to remove or block DSA and to inhibit antibody production. PMID: 26281149 [PubMed - indexed for MEDLINE]
Source: Clinical Transplants - Category: Transplant Surgery Tags: Clin Transpl Source Type: research