Intravenous immunoglobulin and thymoglobulin facilitate kidney transplantation in complement-dependent cytotoxicity B-cell and flow cytometry T- or B-cell crossmatch-positive patients

Enver Akalin, Scott Ames, Vinita Sehgal, Marilena Fotino, Lisa Daly, Barbara Murphy, Jonathan S. Bromberg

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Background. The aim of this study was to investigate the effect of Thymoglobulin and intravenous immunoglobulin (IVIG) therapy on the clinical outcome of a putatively high-risk group of kidney transplant recipients who have positive B-cell complement-dependent cytotoxicity (CDC) along with positive T- or B-cell flow cytometry (FC) crossmatch results. Methods. We prospectively studied the effects of IVIG and Thymoglobulin induction treatment in B-cell CDC, and T- or B-cell FC crossmatch-positive kidney transplant recipients (seven women and one man; mean age, 43±12 years). Results. Mean peak panel-reactive antibody (PRA) was 47±32. Three patients had donor-specific antibody by flow PRA (two anti-DR4 and one anti-A2). Each recipient received induction treatment with IVIG 100 mg/kg for 3 days and Thymoglobulin 1.5 mg/kg for 5 days after transplantation. No acute cellular rejections occurred during a median follow-up of 15 months (range, 12-17 months). Only one acute humoral rejection occurred 8 days after transplantation, which responded to plasmapheresis, IVIG, and rituximab. One allograft was lost because of polyoma nephritis. Patient survival was 100% and allograft survival was 88%. Conclusion. Our results indicate that IVIG and Thymoglobulin induction treatment may facilitate kidney transplantation in B-cell CDC and T- or B-cell FC crossmatch-positive patients.

Original languageEnglish (US)
Pages (from-to)1444-1447
Number of pages4
JournalTransplantation
Volume76
Issue number10
DOIs
StatePublished - Nov 27 2003
Externally publishedYes

Fingerprint

Intravenous Immunoglobulins
Kidney Transplantation
Flow Cytometry
B-Lymphocytes
Allografts
Transplantation
Kidney
Passive Immunization
Plasmapheresis
Antibodies
Nephritis
varespladib methyl
thymoglobulin
Anti-Idiotypic Antibodies
Therapeutics
Tissue Donors
Survival

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Intravenous immunoglobulin and thymoglobulin facilitate kidney transplantation in complement-dependent cytotoxicity B-cell and flow cytometry T- or B-cell crossmatch-positive patients. / Akalin, Enver; Ames, Scott; Sehgal, Vinita; Fotino, Marilena; Daly, Lisa; Murphy, Barbara; Bromberg, Jonathan S.

In: Transplantation, Vol. 76, No. 10, 27.11.2003, p. 1444-1447.

Research output: Contribution to journalArticle

Akalin, Enver ; Ames, Scott ; Sehgal, Vinita ; Fotino, Marilena ; Daly, Lisa ; Murphy, Barbara ; Bromberg, Jonathan S. / Intravenous immunoglobulin and thymoglobulin facilitate kidney transplantation in complement-dependent cytotoxicity B-cell and flow cytometry T- or B-cell crossmatch-positive patients. In: Transplantation. 2003 ; Vol. 76, No. 10. pp. 1444-1447.
@article{9edf2a12d16940bbbf3347bf0a5abd78,
title = "Intravenous immunoglobulin and thymoglobulin facilitate kidney transplantation in complement-dependent cytotoxicity B-cell and flow cytometry T- or B-cell crossmatch-positive patients",
abstract = "Background. The aim of this study was to investigate the effect of Thymoglobulin and intravenous immunoglobulin (IVIG) therapy on the clinical outcome of a putatively high-risk group of kidney transplant recipients who have positive B-cell complement-dependent cytotoxicity (CDC) along with positive T- or B-cell flow cytometry (FC) crossmatch results. Methods. We prospectively studied the effects of IVIG and Thymoglobulin induction treatment in B-cell CDC, and T- or B-cell FC crossmatch-positive kidney transplant recipients (seven women and one man; mean age, 43±12 years). Results. Mean peak panel-reactive antibody (PRA) was 47±32. Three patients had donor-specific antibody by flow PRA (two anti-DR4 and one anti-A2). Each recipient received induction treatment with IVIG 100 mg/kg for 3 days and Thymoglobulin 1.5 mg/kg for 5 days after transplantation. No acute cellular rejections occurred during a median follow-up of 15 months (range, 12-17 months). Only one acute humoral rejection occurred 8 days after transplantation, which responded to plasmapheresis, IVIG, and rituximab. One allograft was lost because of polyoma nephritis. Patient survival was 100{\%} and allograft survival was 88{\%}. Conclusion. Our results indicate that IVIG and Thymoglobulin induction treatment may facilitate kidney transplantation in B-cell CDC and T- or B-cell FC crossmatch-positive patients.",
author = "Enver Akalin and Scott Ames and Vinita Sehgal and Marilena Fotino and Lisa Daly and Barbara Murphy and Bromberg, {Jonathan S.}",
year = "2003",
month = "11",
day = "27",
doi = "10.1097/01.TP.0000084200.40159.EC",
language = "English (US)",
volume = "76",
pages = "1444--1447",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Intravenous immunoglobulin and thymoglobulin facilitate kidney transplantation in complement-dependent cytotoxicity B-cell and flow cytometry T- or B-cell crossmatch-positive patients

AU - Akalin, Enver

AU - Ames, Scott

AU - Sehgal, Vinita

AU - Fotino, Marilena

AU - Daly, Lisa

AU - Murphy, Barbara

AU - Bromberg, Jonathan S.

PY - 2003/11/27

Y1 - 2003/11/27

N2 - Background. The aim of this study was to investigate the effect of Thymoglobulin and intravenous immunoglobulin (IVIG) therapy on the clinical outcome of a putatively high-risk group of kidney transplant recipients who have positive B-cell complement-dependent cytotoxicity (CDC) along with positive T- or B-cell flow cytometry (FC) crossmatch results. Methods. We prospectively studied the effects of IVIG and Thymoglobulin induction treatment in B-cell CDC, and T- or B-cell FC crossmatch-positive kidney transplant recipients (seven women and one man; mean age, 43±12 years). Results. Mean peak panel-reactive antibody (PRA) was 47±32. Three patients had donor-specific antibody by flow PRA (two anti-DR4 and one anti-A2). Each recipient received induction treatment with IVIG 100 mg/kg for 3 days and Thymoglobulin 1.5 mg/kg for 5 days after transplantation. No acute cellular rejections occurred during a median follow-up of 15 months (range, 12-17 months). Only one acute humoral rejection occurred 8 days after transplantation, which responded to plasmapheresis, IVIG, and rituximab. One allograft was lost because of polyoma nephritis. Patient survival was 100% and allograft survival was 88%. Conclusion. Our results indicate that IVIG and Thymoglobulin induction treatment may facilitate kidney transplantation in B-cell CDC and T- or B-cell FC crossmatch-positive patients.

AB - Background. The aim of this study was to investigate the effect of Thymoglobulin and intravenous immunoglobulin (IVIG) therapy on the clinical outcome of a putatively high-risk group of kidney transplant recipients who have positive B-cell complement-dependent cytotoxicity (CDC) along with positive T- or B-cell flow cytometry (FC) crossmatch results. Methods. We prospectively studied the effects of IVIG and Thymoglobulin induction treatment in B-cell CDC, and T- or B-cell FC crossmatch-positive kidney transplant recipients (seven women and one man; mean age, 43±12 years). Results. Mean peak panel-reactive antibody (PRA) was 47±32. Three patients had donor-specific antibody by flow PRA (two anti-DR4 and one anti-A2). Each recipient received induction treatment with IVIG 100 mg/kg for 3 days and Thymoglobulin 1.5 mg/kg for 5 days after transplantation. No acute cellular rejections occurred during a median follow-up of 15 months (range, 12-17 months). Only one acute humoral rejection occurred 8 days after transplantation, which responded to plasmapheresis, IVIG, and rituximab. One allograft was lost because of polyoma nephritis. Patient survival was 100% and allograft survival was 88%. Conclusion. Our results indicate that IVIG and Thymoglobulin induction treatment may facilitate kidney transplantation in B-cell CDC and T- or B-cell FC crossmatch-positive patients.

UR - http://www.scopus.com/inward/record.url?scp=0344152882&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0344152882&partnerID=8YFLogxK

U2 - 10.1097/01.TP.0000084200.40159.EC

DO - 10.1097/01.TP.0000084200.40159.EC

M3 - Article

VL - 76

SP - 1444

EP - 1447

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 10

ER -