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The Effect of Combination Therapy with Rituximab and Intravenous Immunoglobulin on the Progression of Chronic Antibody Mediated Rejection in Renal Transplant Recipients

The treatment for chronic active antibody-mediated rejection (CAMR) remains controversial. We investigated the efficacy of rituximab (RTX) and intravenous immunoglobulin (IVIg) for CAMR. Eighteen patients with CAMR were treated with RTX (375 mg/m(2)) and IVIg (0.4 g/kg) for 4 days. The efficacy of R...

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Autores principales: An, Gun Hee, Yun, Jintak, Hong, Yu Ah, Khvan, Marina, Chung, Byung Ha, Choi, Bum Soon, Park, Cheol Whee, Choi, Yeong Jin, Kim, Yong-Soo, Yang, Chul Woo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987969/
https://www.ncbi.nlm.nih.gov/pubmed/24741626
http://dx.doi.org/10.1155/2014/828732
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author An, Gun Hee
Yun, Jintak
Hong, Yu Ah
Khvan, Marina
Chung, Byung Ha
Choi, Bum Soon
Park, Cheol Whee
Choi, Yeong Jin
Kim, Yong-Soo
Yang, Chul Woo
author_facet An, Gun Hee
Yun, Jintak
Hong, Yu Ah
Khvan, Marina
Chung, Byung Ha
Choi, Bum Soon
Park, Cheol Whee
Choi, Yeong Jin
Kim, Yong-Soo
Yang, Chul Woo
author_sort An, Gun Hee
collection PubMed
description The treatment for chronic active antibody-mediated rejection (CAMR) remains controversial. We investigated the efficacy of rituximab (RTX) and intravenous immunoglobulin (IVIg) for CAMR. Eighteen patients with CAMR were treated with RTX (375 mg/m(2)) and IVIg (0.4 g/kg) for 4 days. The efficacy of RTX/IVIg combination therapy (RIT) was assessed by decline in estimated glomerular filtration rate per month (ΔeGFR) before and after RIT. Patients were divided into responder and nonresponder groups based on decrease and no decrease in ΔeGFR, respectively, and their clinical and histological characteristics were compared. Response rate to RIT was 66.7% (12/18), and overall ΔeGFR decreased significantly to 0.4 ± 1.7 mL·min(−1) ·1.73 m(−2) per month 6 months after RIT compared to that observed 6 months before RIT (1.8 ± 1.0, P < 0.05). Clinical and histological features between the 12 responders and the 6 nonresponders were not significantly different, but nonresponders had a significantly higher proteinuria levels at the time of RIT (2.5 ± 2.5 versus 7.0 ± 3.5 protein/creatinine (g/g), P < 0.001). The effect of the RIT on ΔeGFR had dissipated in all patients by 1 year post-RIT. Thus, RIT delayed CAMR progression, and baseline proteinuria level was a prognostic factor for response to RIT.
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spelling pubmed-39879692014-04-16 The Effect of Combination Therapy with Rituximab and Intravenous Immunoglobulin on the Progression of Chronic Antibody Mediated Rejection in Renal Transplant Recipients An, Gun Hee Yun, Jintak Hong, Yu Ah Khvan, Marina Chung, Byung Ha Choi, Bum Soon Park, Cheol Whee Choi, Yeong Jin Kim, Yong-Soo Yang, Chul Woo J Immunol Res Clinical Study The treatment for chronic active antibody-mediated rejection (CAMR) remains controversial. We investigated the efficacy of rituximab (RTX) and intravenous immunoglobulin (IVIg) for CAMR. Eighteen patients with CAMR were treated with RTX (375 mg/m(2)) and IVIg (0.4 g/kg) for 4 days. The efficacy of RTX/IVIg combination therapy (RIT) was assessed by decline in estimated glomerular filtration rate per month (ΔeGFR) before and after RIT. Patients were divided into responder and nonresponder groups based on decrease and no decrease in ΔeGFR, respectively, and their clinical and histological characteristics were compared. Response rate to RIT was 66.7% (12/18), and overall ΔeGFR decreased significantly to 0.4 ± 1.7 mL·min(−1) ·1.73 m(−2) per month 6 months after RIT compared to that observed 6 months before RIT (1.8 ± 1.0, P < 0.05). Clinical and histological features between the 12 responders and the 6 nonresponders were not significantly different, but nonresponders had a significantly higher proteinuria levels at the time of RIT (2.5 ± 2.5 versus 7.0 ± 3.5 protein/creatinine (g/g), P < 0.001). The effect of the RIT on ΔeGFR had dissipated in all patients by 1 year post-RIT. Thus, RIT delayed CAMR progression, and baseline proteinuria level was a prognostic factor for response to RIT. Hindawi Publishing Corporation 2014 2014-01-29 /pmc/articles/PMC3987969/ /pubmed/24741626 http://dx.doi.org/10.1155/2014/828732 Text en Copyright © 2014 Gun Hee An et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
An, Gun Hee
Yun, Jintak
Hong, Yu Ah
Khvan, Marina
Chung, Byung Ha
Choi, Bum Soon
Park, Cheol Whee
Choi, Yeong Jin
Kim, Yong-Soo
Yang, Chul Woo
The Effect of Combination Therapy with Rituximab and Intravenous Immunoglobulin on the Progression of Chronic Antibody Mediated Rejection in Renal Transplant Recipients
title The Effect of Combination Therapy with Rituximab and Intravenous Immunoglobulin on the Progression of Chronic Antibody Mediated Rejection in Renal Transplant Recipients
title_full The Effect of Combination Therapy with Rituximab and Intravenous Immunoglobulin on the Progression of Chronic Antibody Mediated Rejection in Renal Transplant Recipients
title_fullStr The Effect of Combination Therapy with Rituximab and Intravenous Immunoglobulin on the Progression of Chronic Antibody Mediated Rejection in Renal Transplant Recipients
title_full_unstemmed The Effect of Combination Therapy with Rituximab and Intravenous Immunoglobulin on the Progression of Chronic Antibody Mediated Rejection in Renal Transplant Recipients
title_short The Effect of Combination Therapy with Rituximab and Intravenous Immunoglobulin on the Progression of Chronic Antibody Mediated Rejection in Renal Transplant Recipients
title_sort effect of combination therapy with rituximab and intravenous immunoglobulin on the progression of chronic antibody mediated rejection in renal transplant recipients
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987969/
https://www.ncbi.nlm.nih.gov/pubmed/24741626
http://dx.doi.org/10.1155/2014/828732
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