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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2019.1
- 수록면
- 153 - 158 (6page)
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초록· 키워드
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For successful human leukocyte antigen-incompatible (HLAi) or ABO-incompatible (ABOi) living-donor kidney transplantations (LDKTs), pretransplant desensitization is essential; however, early antibody-mediated rejection (ABMR) remains the most important complication after HLAi or ABOi transplantation. Here, we report a case of early acute ABMR in simultaneous HLAi and ABOi LDKT with preformed donor-specific antibody (DSA), despite desensitization. Dialysis-dependent, severe ABMR occurred with a rebound of pre-existing DSA and appearance of de novo DSA after initial normalization of renal function, 8 days postoperatively. However, a low anti-ABO antibody titer (1:8) was maintained after transplantation. Combination therapy of plasmapheresis, high-dose intravenous immunoglobulin, and bortezomib improved both ABMR and renal functions. Thus, an appropriate preventive and therapeutic management for early ABMR is important among high-risk LDKT patients. Furthermore, early AMBR can occur despite pretransplant desensitization as seen in this case, and close monitoring of the patient and prompt management are considered vital for better therapeutic outcomes.
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참고문헌 (15)
참고문헌 신청
Davis S / 2017 / Acute antibody-mediated rejection in kidney transplant recipients / Transplant Rev (Orlando) 31:47~54
Cardinal H / 2017 / The emerging importance of non-HLA autoantibodies in kidney transplant complications / J Am Soc Nephrol 28:400~406
Tasaki M / 2016 / Frontiers in transplantology / Rijeka:InTech :285~300
Kwun J / 2017 / Humoral compensation after bortezomib treatment of allosensitized recipients / J Am Soc Nephrol 28:1991~1996
Haas M / 2018 / The Banff 2017 Kidney Meeting Report:revised diagnostic criteria for chronic active T cell-mediated rejection, antibody-mediated rejection, and prospects for integrative endpoints for next-generation clinical trials / Am J Transplant 18:293~307
Cardinal H / 2017 / The emerging importance of non-HLA autoantibodies in kidney transplant complications / J Am Soc Nephrol 28:400~406
Tasaki M / 2016 / Frontiers in transplantology / Rijeka:InTech :285~300
Kwun J / 2017 / Humoral compensation after bortezomib treatment of allosensitized recipients / J Am Soc Nephrol 28:1991~1996
Haas M / 2018 / The Banff 2017 Kidney Meeting Report:revised diagnostic criteria for chronic active T cell-mediated rejection, antibody-mediated rejection, and prospects for integrative endpoints for next-generation clinical trials / Am J Transplant 18:293~307
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