A Case of Delayed Recovery from Antibody-Mediated Rejection / 대한내과학회지
Korean Journal of Medicine
;
: 237-241, 2014.
Article
in Korean
| WPRIM
| ID: wpr-81271
ABSTRACT
Antibody-mediated rejection (ABMR) in kidney transplant recipients is mediated by donor-specific antibodies. It is the major cause of graft failure in noncompliant patients and is associated with reduced long-term graft survival. We present a case of delayed recovery of renal function despite aggressive therapy after acute ABMR. A 49-year-old male on triple-drug maintenance immunosuppression (prednisolone, cyclosporine, and azathioprine), who underwent cadaveric donor renal transplantation 14 years earlier, visited our clinic with a serum creatinine level (SCr) of 1.9 mg/dL. The kidney biopsy revealed acute ABMR with diffuse C4d immunopositivity. We started steroid pulse therapy and bortezomib with plasmapheresis. Nevertheless, the SCr increased. Consequently, antithymocyte globulin (ATG) and intravenous immunoglobulin were administered. The SCr increased further to 4.1 mg/dL. Therefore, we performed a second kidney biopsy, which showed no change. Finally, we used rituximab. Fortunately, the SCr decreased gradually and returned to baseline.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Tissue Donors
/
Transplantation
/
Biopsy
/
Cadaver
/
Immunoglobulins
/
Immunosuppression Therapy
/
Kidney Transplantation
/
Plasmapheresis
/
Cyclosporine
/
Transplants
Limits:
Humans
/
Male
Language:
Korean
Journal:
Korean Journal of Medicine
Year:
2014
Type:
Article
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