Induction treatment by combining immunoglobulins, plasmapheresis and rituximab in hypersensitive patients receiving cadaveric renal allograft
In our Universitary Hospital of Canarias we iniciated in May 2008 a induction therapy protocol for sensitized patients receiving cadaveric renal graft using intravenous immunoglobulins, plasmapheresis and rituximab plus immunosuppression with prednisone, tacrolimus and mycophenolate mofetil. We pres...
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| Veröffentlicht in: | Nefrología 2010, Vol.30 (2), p.252-257 |
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| creator | Rufino Hernández, J M Cabello Moya, E González-Posada, J M Hernández Marrero, D Pérez Tamajón, L Marrero Miranda, D García Rebollo, S Martín Urcuyo, B Rodríguez Hernández, A Franco Maside, A Barrios del Pino, Y Rodríguez Rodríguez, R Maceira Cruz, B Torres Ramírez, A Salido Ruiz, E |
| description | In our Universitary Hospital of Canarias we iniciated in May 2008 a induction therapy protocol for sensitized patients receiving cadaveric renal graft using intravenous immunoglobulins, plasmapheresis and rituximab plus immunosuppression with prednisone, tacrolimus and mycophenolate mofetil. We present the results of four patients. Everyone had anti-HLA antibodies rate (PRA by CDC) more than 75%, were on a waiting list during 4 to 17 years and follow-up time was 10-14 months after transplantation. Patient and graft survival in this period was 100%. Only one patient suffered a humoral acute rejection and another one cellular rejection, in both cases reversible with treatment. During the first year, no evidence of de novo donor-specific antibodies was detected. All patients had significantly reduced the CD19+ cells percentage after infusion of rituximab. Neurological symptoms suggestive of progressive multifocal leukoencephalopathy or serious viral infections after transplantation have not been observed. Additionally, no immediate side effects were observed after administration of medication. In summary, induction therapy by combining immunoglobulin, plasmapheresis and rituximab in hypersensitive patients allows the realization of deceased kidney transplantation with good results in the short and medium-term without serious side effects. It remains to know whether this success will continue in the long term. |
| doi_str_mv | 10.3265/Nefrologia.pre2010.Jan.10233 |
| format | Article |
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We present the results of four patients. Everyone had anti-HLA antibodies rate (PRA by CDC) more than 75%, were on a waiting list during 4 to 17 years and follow-up time was 10-14 months after transplantation. Patient and graft survival in this period was 100%. Only one patient suffered a humoral acute rejection and another one cellular rejection, in both cases reversible with treatment. During the first year, no evidence of de novo donor-specific antibodies was detected. All patients had significantly reduced the CD19+ cells percentage after infusion of rituximab. Neurological symptoms suggestive of progressive multifocal leukoencephalopathy or serious viral infections after transplantation have not been observed. Additionally, no immediate side effects were observed after administration of medication. In summary, induction therapy by combining immunoglobulin, plasmapheresis and rituximab in hypersensitive patients allows the realization of deceased kidney transplantation with good results in the short and medium-term without serious side effects. It remains to know whether this success will continue in the long term.</description><identifier>ISSN: 0211-6995</identifier><identifier>DOI: 10.3265/Nefrologia.pre2010.Jan.10233</identifier><identifier>PMID: 20098463</identifier><language>spa</language><publisher>Spain</publisher><subject><![CDATA[Antibodies, Monoclonal - administration & dosage ; Antibodies, Monoclonal - therapeutic use ; Antibodies, Monoclonal, Murine-Derived ; Cadaver ; Combined Modality Therapy ; Female ; Graft Rejection - prevention & control ; Histocompatibility ; HLA Antigens - immunology ; Humans ; Immunization ; Immunoglobulins, Intravenous - administration & dosage ; Immunoglobulins, Intravenous - therapeutic use ; Immunosuppressive Agents - administration & dosage ; Immunosuppressive Agents - therapeutic use ; Isoantibodies - blood ; Kidney Failure, Chronic - immunology ; Kidney Failure, Chronic - surgery ; Kidney Transplantation - immunology ; Male ; Middle Aged ; Mycophenolic Acid - administration & dosage ; Mycophenolic Acid - analogs & derivatives ; Mycophenolic Acid - therapeutic use ; Plasmapheresis ; Prednisone - administration & dosage ; Prednisone - therapeutic use ; Premedication ; Reoperation ; Rituximab ; Tacrolimus - administration & dosage ; Tacrolimus - therapeutic use ; Tissue Donors]]></subject><ispartof>Nefrología, 2010, Vol.30 (2), p.252-257</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,4010,27904,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20098463$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rufino Hernández, J M</creatorcontrib><creatorcontrib>Cabello Moya, E</creatorcontrib><creatorcontrib>González-Posada, J M</creatorcontrib><creatorcontrib>Hernández Marrero, D</creatorcontrib><creatorcontrib>Pérez Tamajón, L</creatorcontrib><creatorcontrib>Marrero Miranda, D</creatorcontrib><creatorcontrib>García Rebollo, S</creatorcontrib><creatorcontrib>Martín Urcuyo, B</creatorcontrib><creatorcontrib>Rodríguez Hernández, A</creatorcontrib><creatorcontrib>Franco Maside, A</creatorcontrib><creatorcontrib>Barrios del Pino, Y</creatorcontrib><creatorcontrib>Rodríguez Rodríguez, R</creatorcontrib><creatorcontrib>Maceira Cruz, B</creatorcontrib><creatorcontrib>Torres Ramírez, A</creatorcontrib><creatorcontrib>Salido Ruiz, E</creatorcontrib><title>Induction treatment by combining immunoglobulins, plasmapheresis and rituximab in hypersensitive patients receiving cadaveric renal allograft</title><title>Nefrología</title><addtitle>Nefrologia</addtitle><description>In our Universitary Hospital of Canarias we iniciated in May 2008 a induction therapy protocol for sensitized patients receiving cadaveric renal graft using intravenous immunoglobulins, plasmapheresis and rituximab plus immunosuppression with prednisone, tacrolimus and mycophenolate mofetil. We present the results of four patients. Everyone had anti-HLA antibodies rate (PRA by CDC) more than 75%, were on a waiting list during 4 to 17 years and follow-up time was 10-14 months after transplantation. Patient and graft survival in this period was 100%. Only one patient suffered a humoral acute rejection and another one cellular rejection, in both cases reversible with treatment. During the first year, no evidence of de novo donor-specific antibodies was detected. All patients had significantly reduced the CD19+ cells percentage after infusion of rituximab. Neurological symptoms suggestive of progressive multifocal leukoencephalopathy or serious viral infections after transplantation have not been observed. Additionally, no immediate side effects were observed after administration of medication. 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Cabello Moya, E ; González-Posada, J M ; Hernández Marrero, D ; Pérez Tamajón, L ; Marrero Miranda, D ; García Rebollo, S ; Martín Urcuyo, B ; Rodríguez Hernández, A ; Franco Maside, A ; Barrios del Pino, Y ; Rodríguez Rodríguez, R ; Maceira Cruz, B ; Torres Ramírez, A ; Salido Ruiz, E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p140t-92df25e5d22780ac31fa6db0e1e30b467f7776d205036d97af82cfb57ff556933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>spa</language><creationdate>2010</creationdate><topic>Antibodies, Monoclonal - administration & dosage</topic><topic>Antibodies, Monoclonal - therapeutic use</topic><topic>Antibodies, Monoclonal, Murine-Derived</topic><topic>Cadaver</topic><topic>Combined Modality Therapy</topic><topic>Female</topic><topic>Graft Rejection - prevention & control</topic><topic>Histocompatibility</topic><topic>HLA Antigens - immunology</topic><topic>Humans</topic><topic>Immunization</topic><topic>Immunoglobulins, Intravenous - administration & dosage</topic><topic>Immunoglobulins, Intravenous - therapeutic use</topic><topic>Immunosuppressive Agents - administration & dosage</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Isoantibodies - blood</topic><topic>Kidney Failure, Chronic - immunology</topic><topic>Kidney Failure, Chronic - surgery</topic><topic>Kidney Transplantation - immunology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mycophenolic Acid - administration & dosage</topic><topic>Mycophenolic Acid - analogs & derivatives</topic><topic>Mycophenolic Acid - therapeutic use</topic><topic>Plasmapheresis</topic><topic>Prednisone - administration & dosage</topic><topic>Prednisone - therapeutic use</topic><topic>Premedication</topic><topic>Reoperation</topic><topic>Rituximab</topic><topic>Tacrolimus - administration & dosage</topic><topic>Tacrolimus - therapeutic use</topic><topic>Tissue Donors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rufino Hernández, J M</creatorcontrib><creatorcontrib>Cabello Moya, E</creatorcontrib><creatorcontrib>González-Posada, J M</creatorcontrib><creatorcontrib>Hernández Marrero, D</creatorcontrib><creatorcontrib>Pérez Tamajón, L</creatorcontrib><creatorcontrib>Marrero Miranda, D</creatorcontrib><creatorcontrib>García Rebollo, S</creatorcontrib><creatorcontrib>Martín Urcuyo, B</creatorcontrib><creatorcontrib>Rodríguez Hernández, A</creatorcontrib><creatorcontrib>Franco Maside, A</creatorcontrib><creatorcontrib>Barrios del Pino, Y</creatorcontrib><creatorcontrib>Rodríguez Rodríguez, R</creatorcontrib><creatorcontrib>Maceira Cruz, B</creatorcontrib><creatorcontrib>Torres Ramírez, A</creatorcontrib><creatorcontrib>Salido Ruiz, E</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Nefrología</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rufino Hernández, J M</au><au>Cabello Moya, E</au><au>González-Posada, J M</au><au>Hernández Marrero, D</au><au>Pérez Tamajón, L</au><au>Marrero Miranda, D</au><au>García Rebollo, S</au><au>Martín Urcuyo, B</au><au>Rodríguez Hernández, A</au><au>Franco Maside, A</au><au>Barrios del Pino, Y</au><au>Rodríguez Rodríguez, R</au><au>Maceira Cruz, B</au><au>Torres Ramírez, A</au><au>Salido Ruiz, E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Induction treatment by combining immunoglobulins, plasmapheresis and rituximab in hypersensitive patients receiving cadaveric renal allograft</atitle><jtitle>Nefrología</jtitle><addtitle>Nefrologia</addtitle><date>2010</date><risdate>2010</risdate><volume>30</volume><issue>2</issue><spage>252</spage><epage>257</epage><pages>252-257</pages><issn>0211-6995</issn><abstract>In our Universitary Hospital of Canarias we iniciated in May 2008 a induction therapy protocol for sensitized patients receiving cadaveric renal graft using intravenous immunoglobulins, plasmapheresis and rituximab plus immunosuppression with prednisone, tacrolimus and mycophenolate mofetil. We present the results of four patients. Everyone had anti-HLA antibodies rate (PRA by CDC) more than 75%, were on a waiting list during 4 to 17 years and follow-up time was 10-14 months after transplantation. Patient and graft survival in this period was 100%. Only one patient suffered a humoral acute rejection and another one cellular rejection, in both cases reversible with treatment. During the first year, no evidence of de novo donor-specific antibodies was detected. All patients had significantly reduced the CD19+ cells percentage after infusion of rituximab. Neurological symptoms suggestive of progressive multifocal leukoencephalopathy or serious viral infections after transplantation have not been observed. Additionally, no immediate side effects were observed after administration of medication. In summary, induction therapy by combining immunoglobulin, plasmapheresis and rituximab in hypersensitive patients allows the realization of deceased kidney transplantation with good results in the short and medium-term without serious side effects. It remains to know whether this success will continue in the long term.</abstract><cop>Spain</cop><pmid>20098463</pmid><doi>10.3265/Nefrologia.pre2010.Jan.10233</doi><tpages>6</tpages></addata></record> |
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| subjects | Antibodies, Monoclonal - administration & dosage Antibodies, Monoclonal - therapeutic use Antibodies, Monoclonal, Murine-Derived Cadaver Combined Modality Therapy Female Graft Rejection - prevention & control Histocompatibility HLA Antigens - immunology Humans Immunization Immunoglobulins, Intravenous - administration & dosage Immunoglobulins, Intravenous - therapeutic use Immunosuppressive Agents - administration & dosage Immunosuppressive Agents - therapeutic use Isoantibodies - blood Kidney Failure, Chronic - immunology Kidney Failure, Chronic - surgery Kidney Transplantation - immunology Male Middle Aged Mycophenolic Acid - administration & dosage Mycophenolic Acid - analogs & derivatives Mycophenolic Acid - therapeutic use Plasmapheresis Prednisone - administration & dosage Prednisone - therapeutic use Premedication Reoperation Rituximab Tacrolimus - administration & dosage Tacrolimus - therapeutic use Tissue Donors |
| title | Induction treatment by combining immunoglobulins, plasmapheresis and rituximab in hypersensitive patients receiving cadaveric renal allograft |
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