Please use this identifier to cite or link to this item:
Title: Rituximab, plasma exchange and immunoglobulins: an ineffective treatment for chronic active antibody-mediated rejection
Author: Piñeiro, Gaston Julio
Sousa Amorim, Erika de
Solé, Manel
Ríos, José
Lozano Molero, Miguel
Cofán Pujol, Federico
Ventura Aguiar, Pedro
Cucchiari, David
Revuelta, Ignacio
Cid Vidal, Joan
Palou, Eduard
Campistol Plana, Josep M.
Oppenheimer Salinas, Federico
Rovira, Jordi
Diekmann, Fritz
Keywords: Trasplantament renal
Utilització de medicaments
Kidney transplantation
Drug utilization
Issue Date: 11-Oct-2018
Publisher: BioMed Central
Abstract: BACKGROUND: Chronic active antibody-mediated rejection (c-aABMR) is an important cause of allograft failure and graft loss in long-term kidney transplants. METHODS: To determine the efficacy and safety of combined therapy with rituximab, plasma exchange (PE) and intravenous immunoglobulins (IVIG), a cohort of patients with transplant glomerulopathy (TG) that met criteria of active cABMR, according to BANFF'17 classification, was identified. RESULTS: We identified 62 patients with active c-aABMR and TG (cg ≥ 1). Twenty-three patients were treated with the combination therapy and, 39 patients did not receive treatment and were considered the control group. There were no significant differences in the graft survival between the two groups. The number of graft losses at 12 and 24 months and the decline of eGFR were not different and independent of the treatment. A decrease of eGFR≥13 ml/min between 6 months before and c-aABMR diagnosis, was an independent risk factor for graft loss at 24 months (OR = 5; P = 0.01). Infections that required hospitalization during the first year after c-aABMR diagnosis were significantly more frequent in treated patients (OR = 4.22; P = 0.013), with a ratio infection/patient-year of 0.65 and 0.20 respectively. CONCLUSIONS: Treatment with rituximab, PE, and IVIG in kidney transplants with c-aABMR did not improve graft survival and was associated with a significant increase in severe infectious complications.
Note: Reproducció del document publicat a:
It is part of: BMC Nephrology, 2018, vol. 19, num. 1, p. 261
Related resource:
ISSN: 1471-2369
Appears in Collections:Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (Medicina)

Files in This Item:
File Description SizeFormat 
682504.pdf709.39 kBAdobe PDFView/Open

This item is licensed under a Creative Commons License Creative Commons