Successful rescue therapy with plasmapheresis and intravenous immunoglobulin for acute humoral renal transplant rejection

Nicole B. White, Stuart M. Greenstein, Alex W. Cantafio, Richard Schechner, Daniel Glicklich, Patricia McDonough, James M. Pullman, Kala Mohandas, Fouad Boctor, Joan Uehlinger, Vivian Tellis

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

Plasmapheresis (PP) and intravenous immunoglobulin (IVIg) remove donor-specific antibodies, a cause of acute humoral rejection (AHR). We describe the use of PP and IVIg as rescue therapy for AHR. The records of 143 renal transplants performed between October 1, 2000 and April 1, 2002 were reviewed. Patients who underwent PP and IVIg therapy for AHR were identified. The data reviewed included age, sex, source of transplant, number of human leukocyte antigen mismatches, transplant number, number of PP and IVIg treatments, dose of IVIg, time of AHR, serum creatinine (SCr) level at AHR, SCr level after PP and IVIg at 3 months, days to achieve 30% decline in SCr, and graft survival. Immunosuppression included basiliximab induction, tacrolimus, and prednisone (± sirolimus or mycophenolate mofetil [CellCept, Roche Pharmaceutical, Nutley, NJ]). PP was followed by IVIG infusion. Nine patients were treated for AHR with PP and IVIg. All nine patients demonstrated biopsy-proven AHR. One graft was lost. Mean 3-month and 1-year SCr levels were 1.9 and 1.8, respectively, in the remaining eight patients. AHR in renal transplantation can be effectively treated with PP and IVIg.

Original languageEnglish (US)
Pages (from-to)772-774
Number of pages3
JournalTransplantation
Volume78
Issue number5
DOIs
StatePublished - Sep 15 2004

Fingerprint

Plasmapheresis
Intravenous Immunoglobulins
Graft Rejection
Kidney
Creatinine
Mycophenolic Acid
Transplants
Therapeutics
Serum
Passive Immunization
Tacrolimus
Graft Survival
Sirolimus
HLA Antigens
Prednisone
Kidney Transplantation
Immunosuppression
Tissue Donors
Biopsy
Antibodies

Keywords

  • Humoral
  • IVIg
  • Plasmapheresis

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Successful rescue therapy with plasmapheresis and intravenous immunoglobulin for acute humoral renal transplant rejection. / White, Nicole B.; Greenstein, Stuart M.; Cantafio, Alex W.; Schechner, Richard; Glicklich, Daniel; McDonough, Patricia; Pullman, James M.; Mohandas, Kala; Boctor, Fouad; Uehlinger, Joan; Tellis, Vivian.

In: Transplantation, Vol. 78, No. 5, 15.09.2004, p. 772-774.

Research output: Contribution to journalArticle

White, Nicole B. ; Greenstein, Stuart M. ; Cantafio, Alex W. ; Schechner, Richard ; Glicklich, Daniel ; McDonough, Patricia ; Pullman, James M. ; Mohandas, Kala ; Boctor, Fouad ; Uehlinger, Joan ; Tellis, Vivian. / Successful rescue therapy with plasmapheresis and intravenous immunoglobulin for acute humoral renal transplant rejection. In: Transplantation. 2004 ; Vol. 78, No. 5. pp. 772-774.
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