Long-term experience of plasmapheresis in antibody-mediated rejection in renal transplantation.

Hdl Handle:
http://hdl.handle.net/10147/127202
Title:
Long-term experience of plasmapheresis in antibody-mediated rejection in renal transplantation.
Authors:
Brown, C M; Abraham, K A; O'Kelly, P; Conlon, P J; Walshe, J J
Affiliation:
Department of Nephrology, Beaumont Hospital, Dublin, Ireland. catherinebrownis@gmail.com
Citation:
Long-term experience of plasmapheresis in antibody-mediated rejection in renal transplantation. 2009, 41 (9):3690-2 Transplant. Proc.
Journal:
Transplantation proceedings
Issue Date:
Nov-2009
URI:
http://hdl.handle.net/10147/127202
DOI:
10.1016/j.transproceed.2009.06.197
PubMed ID:
19917368
Abstract:
Antibody-mediated rejection (AMR) continues to pose a serious challenge in renal transplantation with potentially devastating consequences. Treatment options for this condition include plasmapheresis, high-dose intravenous immunoglobulin (IVIG), plasmapheresis with low-dose IVIG, and the use of rituximab (anti-CD20 chimeric antibody). We previously reported on the short-term outcome of plasmapheresis as a rescue therapy for AMR in our centre. We now report on the long-term follow up.; Over a 2.5-year study period, 440 cadaveric transplants were performed. AMR developed in 20 (4.5%) patients. Treatment included plasmapheresis and intensification of their immunosuppressive therapy.; Excluding two patients who had infarcted their grafts at diagnosis, 18 patients received plasmapheresis treatment for AMR. Of the 18 patients treated, 14 recovered function, two developed graft infarction within a fortnight of starting plasmapheresis, and two patients were withdrawn from treatment. In the 14 who recovered renal function, graft survival was 86% at 12 months. In this study we report on the 5-year follow-up of these AMR-treatment responders. Eleven patients have a functioning graft at 5 years; graft function was stable with a mean serum creatinine of 130 micromol/L at 5 years compared to 123 mumol/L at 1 year. At 5-years follow-up; graft survival was 78% and patient survival 93%.; Little information is available in the literature regarding the long-term outcome of this therapy. This is the first report on the long-term (5-year) follow-up of plasmapheresis as a rescue therapy for AMR.
Item Type:
Article
Language:
en
MeSH:
Antibodies, Monoclonal; Antibodies, Monoclonal, Murine-Derived; Cadaver; Creatinine; Graft Rejection; Graft Survival; Humans; Immunoglobulins, Intravenous; Immunosuppressive Agents; Isoantibodies; Kidney Transplantation; Plasmapheresis; Survival Rate; Tissue Donors; Treatment Outcome
ISSN:
1873-2623

Full metadata record

DC FieldValue Language
dc.contributor.authorBrown, C Men
dc.contributor.authorAbraham, K Aen
dc.contributor.authorO'Kelly, Pen
dc.contributor.authorConlon, P Jen
dc.contributor.authorWalshe, J Jen
dc.date.accessioned2011-04-05T14:31:08Z-
dc.date.available2011-04-05T14:31:08Z-
dc.date.issued2009-11-
dc.identifier.citationLong-term experience of plasmapheresis in antibody-mediated rejection in renal transplantation. 2009, 41 (9):3690-2 Transplant. Proc.en
dc.identifier.issn1873-2623-
dc.identifier.pmid19917368-
dc.identifier.doi10.1016/j.transproceed.2009.06.197-
dc.identifier.urihttp://hdl.handle.net/10147/127202-
dc.description.abstractAntibody-mediated rejection (AMR) continues to pose a serious challenge in renal transplantation with potentially devastating consequences. Treatment options for this condition include plasmapheresis, high-dose intravenous immunoglobulin (IVIG), plasmapheresis with low-dose IVIG, and the use of rituximab (anti-CD20 chimeric antibody). We previously reported on the short-term outcome of plasmapheresis as a rescue therapy for AMR in our centre. We now report on the long-term follow up.-
dc.description.abstractOver a 2.5-year study period, 440 cadaveric transplants were performed. AMR developed in 20 (4.5%) patients. Treatment included plasmapheresis and intensification of their immunosuppressive therapy.-
dc.description.abstractExcluding two patients who had infarcted their grafts at diagnosis, 18 patients received plasmapheresis treatment for AMR. Of the 18 patients treated, 14 recovered function, two developed graft infarction within a fortnight of starting plasmapheresis, and two patients were withdrawn from treatment. In the 14 who recovered renal function, graft survival was 86% at 12 months. In this study we report on the 5-year follow-up of these AMR-treatment responders. Eleven patients have a functioning graft at 5 years; graft function was stable with a mean serum creatinine of 130 micromol/L at 5 years compared to 123 mumol/L at 1 year. At 5-years follow-up; graft survival was 78% and patient survival 93%.-
dc.description.abstractLittle information is available in the literature regarding the long-term outcome of this therapy. This is the first report on the long-term (5-year) follow-up of plasmapheresis as a rescue therapy for AMR.-
dc.language.isoenen
dc.subject.meshAntibodies, Monoclonal-
dc.subject.meshAntibodies, Monoclonal, Murine-Derived-
dc.subject.meshCadaver-
dc.subject.meshCreatinine-
dc.subject.meshGraft Rejection-
dc.subject.meshGraft Survival-
dc.subject.meshHumans-
dc.subject.meshImmunoglobulins, Intravenous-
dc.subject.meshImmunosuppressive Agents-
dc.subject.meshIsoantibodies-
dc.subject.meshKidney Transplantation-
dc.subject.meshPlasmapheresis-
dc.subject.meshSurvival Rate-
dc.subject.meshTissue Donors-
dc.subject.meshTreatment Outcome-
dc.titleLong-term experience of plasmapheresis in antibody-mediated rejection in renal transplantation.en
dc.typeArticleen
dc.contributor.departmentDepartment of Nephrology, Beaumont Hospital, Dublin, Ireland. catherinebrownis@gmail.comen
dc.identifier.journalTransplantation proceedingsen
dc.description.provinceLeinster-

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