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Comparison of Combination Plasmapheresis/IVIg/Anti-CD20 Versus High-Dose IVIg in the Treatment of Antibody-Mediated Rejection
| Content Provider | Scilit |
|---|---|
| Author | Lefaucheur, C. Nochy, D. Andrade, J. Verine, J. Gautreau, C. Charron, D. Hill, G. S. Glotz, D. Suberbielle-Boissel, C. |
| Copyright Year | 2009 |
| Description | Journal: American Journal of Transplantation Different strategies appear to improve the success in treatment of antibody-mediated rejection (AMR), although no one best method has yet emerged. The objective of this study was to compare the efficacy of the combination of Plasmapheresis/intravenous immunoglobulin (IVIg)/anti-CD20-based regimes versus high-dose IVIg alone in the treatment of AMR. Group A (12 patients) was treated with high-dose IVIg between January 2000 and December 2003; group B (12 patients) was treated by Plasmapheresis/IVIg/anti-CD20 between January 2004 and December 2005. Graft survival at 36 months was 91.7% in group B versus 50% in group A (p = 0.02). Donor-specific human leukocyte antigens (DSA) levels detected by Luminex single antigen (Luminex SA) and ELISA, 3 months postrejection are significantly lower in group B than in group A: DSA ELISA class 2 score 6-8 (p = 0.02), DSA mean intensity of fluorescence (MFI) max (p = 0.009) and DSA mean MFI (p = 0.0004). The persistence of elevated DSA levels posttreatment is more frequent in patients with graft loss as compared to those with preserved renal function: score 6-8 on ELISA (p = 0.04); mean MFI (p = 0.00009) and MFImax (p = 0.018). We conclude that: (1) high dose IVIg alone is inferior to Plasmapheresis/IVIg/anti-CD20 as therapy for AMR and (2)DSA postrejection can be quantified using solid phase assays, showing that 3 months after AMR, DSA levels are higher in patients with graft loss. |
| Related Links | http://onlinelibrary.wiley.com/doi/10.1111/j.1600-6143.2009.02591.x/pdf |
| Ending Page | 1107 |
| Page Count | 9 |
| Starting Page | 1099 |
| e-ISSN | 16006143 |
| DOI | 10.1111/j.1600-6143.2009.02591.x |
| Journal | American Journal of Transplantation |
| Issue Number | 5 |
| Volume Number | 9 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2009-05-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: American Journal of Transplantation Allograft Survival Anti‐cd20 Monoclonal Antibody Anti‐hla Antibodies Antibody‐mediated Rejection Donor‐specific Antibodies Intravenous Immunoglobulin |
| Content Type | Text |
| Resource Type | Article |
