PMID- 19194545
OWN - NLM
STAT- MEDLINE
DCOM- 20090320
LR  - 20211020
IS  - 1011-8934 (Print)
IS  - 1598-6357 (Electronic)
IS  - 1011-8934 (Linking)
VI  - 24 Suppl
IP  - Suppl 1
DP  - 2009 Jan
TI  - Successful renal transplantation with desensitization in highly sensitized 
      patients: a single center experience.
PG  - S148-55
LID - 10.3346/jkms.2009.24.S1.S148 [doi]
AB  - Intravenous immunoglobulin (IVIG) and/or plasmapheresis (PP) are effective in 
      preventing antibody-mediated rejection (AMR) of kidney allografts, but AMR is 
      still a problem. This study reports our experience in living donor renal 
      transplantation in highly sensitized patients. Ten patients with positive 
      crossmatch tests or high levels of panel-reactive antibody (PRA) were included. 
      Eight patients were desensitized with pretransplant PP and low dose IVIG, and two 
      were additionally treated with rituximab. Allograft function, number of acute 
      rejection (AR) episodes, protocol biopsy findings, and the presence of 
      donor-specific antibody (DSA) were evaluated. With PP/IVIG, six out of eight 
      patients showed good graft function without AR episodes. Protocol biopsies 
      revealed no evidence of tissue injury or C4d deposits. Of two patients with AR, 
      one was successfully treated with PP/IVIG, but the other lost graft function due 
      to de novo production of DSA. Thereafter, rituximab was added to PP/IVIG in two 
      cases. Rituximab gradually decreased PRA levels and the percentage of peripheral 
      CD20+ cells. DSA was undetectable and protocol biopsy showed no C4d deposits. The 
      graft function was stable and there were no AR episodes. Conclusively, 
      desensitization using PP/IVIG with or without rituximab increases the likelihood 
      of successful living donor renal transplantation in sensitized recipients.
FAU - Yoon, Hye Eun
AU  - Yoon HE
AD  - Division of Nephrology, Department of Internal Medicine, Kangnam St. Mary's 
      Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
FAU - Hyoung, Bok Jin
AU  - Hyoung BJ
FAU - Hwang, Hyeon Seok
AU  - Hwang HS
FAU - Lee, So Young
AU  - Lee SY
FAU - Jeon, Youn Joo
AU  - Jeon YJ
FAU - Song, Joon Chang
AU  - Song JC
FAU - Oh, Eun-Jee
AU  - Oh EJ
FAU - Park, Sun Cheol
AU  - Park SC
FAU - Choi, Bum Soon
AU  - Choi BS
FAU - Moon, In Sung
AU  - Moon IS
FAU - Kim, Yong Soo
AU  - Kim YS
FAU - Yang, Chul Woo
AU  - Yang CW
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090128
PL  - Korea (South)
TA  - J Korean Med Sci
JT  - Journal of Korean medical science
JID - 8703518
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Murine-Derived)
RN  - 0 (Antigens, CD20)
RN  - 0 (Immunoglobulins)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Isoantibodies)
RN  - 4F4X42SYQ6 (Rituximab)
SB  - IM
MH  - Adult
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Antibodies, Monoclonal, Murine-Derived
MH  - Antigens, CD20/biosynthesis
MH  - Female
MH  - Humans
MH  - Immunoglobulins/metabolism
MH  - Immunophenotyping
MH  - Immunosuppressive Agents/therapeutic use
MH  - Isoantibodies/chemistry
MH  - Kidney Failure, Chronic/therapy
MH  - Kidney Transplantation/*methods
MH  - Lymphocytes/metabolism
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Rituximab
PMC - PMC2633191
OTO - NOTNLM
OT  - Desensitization
OT  - Immunoglobulins, Intravenous
OT  - Plasmapheresis, Kidney Transplantation
OT  - Rituximab
EDAT- 2009/02/12 09:00
MHDA- 2009/03/21 09:00
PMCR- 2009/01/01
CRDT- 2009/02/06 09:00
PHST- 2008/05/01 00:00 [received]
PHST- 2008/12/03 00:00 [accepted]
PHST- 2009/02/06 09:00 [entrez]
PHST- 2009/02/12 09:00 [pubmed]
PHST- 2009/03/21 09:00 [medline]
PHST- 2009/01/01 00:00 [pmc-release]
AID - 10.3346/jkms.2009.24.S1.S148 [doi]
PST - ppublish
SO  - J Korean Med Sci. 2009 Jan;24 Suppl(Suppl 1):S148-55. doi: 
      10.3346/jkms.2009.24.S1.S148. Epub 2009 Jan 28.