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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 PLoS+One
2017 ; 12
(6
): e0178572
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gab.com Text
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English Wikipedia
Intravenous immunoglobulin therapy in kidney transplant recipients with de novo
DSA: Results of an observational study
#MMPMID28654684
Matignon M
; Pilon C
; Commereuc M
; Grondin C
; Leibler C
; Kofman T
; Audard V
; Cohen J
; Canoui-Poitrine F
; Grimbert P
PLoS One
2017[]; 12
(6
): e0178572
PMID28654684
show ga
BACKGROUND: Approximately 25% of kidney transplant recipients develop de novo
anti-HLA donor-specific antibodies (dnDSA) leading to acute antibody-mediated
rejection (ABMR) in 30% of patients. Preemptive therapeutic strategies are not
available. METHODS: We conducted a prospective observational study including 11
kidney transplant recipients. Inclusion criteria were dnDSA occurring within the
first year after transplant and normal allograft biopsy. All patients were
treated with high-dose IVIG (2 g/kg 0, 1 and 2 months post-dnDSA). The primary
efficacy outcome was incidence of clinical and subclinical acute ABMR within 12
months after dnDSA detection as compared to a historical control group (IVIG-).
RESULTS: Acute ABMR occurred in 2 or 11 patients in the IVIG+ group and in 1 of 9
patients in the IVIG- group. IVIG treatment did not affect either class I or
class II DSA, as observed at the end of the follow-up. IVIG treatment
significantly decreased Fc?RIIA mRNA expression in circulating leukocytes, but
did not affect the expression of any other markers of B cell activation.
CONCLUSIONS: In this first pilot study including kidney allograft recipients with
early dnDSA, preemptive treatment with high-dose IVIG alone did not prevent acute
ABMR and had minimal effects on DSA outcome and B cell phenotype.
|*Kidney Transplantation
[MESH]
|Adult
[MESH]
|Aged
[MESH]
|Female
[MESH]
|Graft Rejection/drug therapy/immunology/*prevention & control
[MESH]
|Graft Survival/*drug effects
[MESH]
|HLA Antigens/immunology
[MESH]
|Humans
[MESH]
|Immunoglobulins, Intravenous/*therapeutic use
[MESH]