Early plasmapheresis and rituximab for acute humoral rejection after ABO-compatible liver transplantation
Acute humoral rejection （AHR） is uncommon after ABO- compatible liver transplantation. Herein, we report two cases of AHR treated with plasmapheresis and rituximab in two ABO-compatible liver-transplant patients with preformed anti-human leukocyte antigen donor-specific antibodies. Patient 1 experie...
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| Veröffentlicht in: | World journal of gastroenterology : WJG 2009-07, Vol.15 (27), p.3426-3430 |
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| creator | Kamar, Nassim Lavayssière, Laurence Muscari, Fabrice Selves, Janick Guilbeau-Frugier, Céline Cardeau, Isabelle Esposito, Laure Cointault, Olivier Nogier, Marie Béatrice Peron, Jean Marie Otal, Philippe Fort, Marylise Rostaing, Lionel |
| description | Acute humoral rejection （AHR） is uncommon after ABO- compatible liver transplantation. Herein, we report two cases of AHR treated with plasmapheresis and rituximab in two ABO-compatible liver-transplant patients with preformed anti-human leukocyte antigen donor-specific antibodies. Patient 1 experienced a biopsy-proven AHR at day 10 post-transplant. She was treated by steroid pulses, and OKT3. Because of persisting signs of biopsy-proven AHR at day 26, she was treated by plasmapheresis and rituximab. Uver enzyme levels did not improve, and she died on day 41. Patient 2 experienced a biopsy-proven AHR on day 10 post-transplant. She was treated by steroid pulses, plasmapheresis, and rituximab. Liver enzymes returned to within normal range 18 d after diagnosis. Uver biopsies, at 3 and 9 mo post-transplant, showed complete resolution of AHR. We conclude that plasmapheresis should be started as soon as AHR is diagnosed, and be associated with a B-cell depleting agent. Rituximab may be considered as a first-line therapy. |
| doi_str_mv | 10.3748/wjg.15.3426 |
| format | Article |
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Herein, we report two cases of AHR treated with plasmapheresis and rituximab in two ABO-compatible liver-transplant patients with preformed anti-human leukocyte antigen donor-specific antibodies. Patient 1 experienced a biopsy-proven AHR at day 10 post-transplant. She was treated by steroid pulses, and OKT3. Because of persisting signs of biopsy-proven AHR at day 26, she was treated by plasmapheresis and rituximab. Uver enzyme levels did not improve, and she died on day 41. Patient 2 experienced a biopsy-proven AHR on day 10 post-transplant. She was treated by steroid pulses, plasmapheresis, and rituximab. Liver enzymes returned to within normal range 18 d after diagnosis. Uver biopsies, at 3 and 9 mo post-transplant, showed complete resolution of AHR. We conclude that plasmapheresis should be started as soon as AHR is diagnosed, and be associated with a B-cell depleting agent. Rituximab may be considered as a first-line therapy.</description><identifier>ISSN: 1007-9327</identifier><identifier>EISSN: 2219-2840</identifier><identifier>DOI: 10.3748/wjg.15.3426</identifier><identifier>PMID: 19610146</identifier><language>eng</language><publisher>United States: INSERM U858,IFR 31,CHU Rangueil,TSA 50032 31059 Toulouse Cédex 9,France%Department of Nephrology,Dialysis and Multi-Organ Transplantation,CHU Rangueil,TSA 50032 31059 Toulouse Cedex 9,France%Department of Liver Transplantation,CHU Rangueil,TSA 50032 31059 Toulouse Cédex 9,France%Department of Histopathology,CHU Purpan,TSA 50032 31059 Toulouse Cédex 9,France%Department of Histopathology,CHU Rangueil,TSA 50032 31059 Toulouse Cédex 9,France%Department of Hepatology,CHU Purpan,TSA 50032 31059 Toulouse Cédex 9,France%Department of Radiology,CHU Rangueil,TSA 50032 31059 Toulouse Cédex 9,France%Department of Immunology,CHU Rangueil,TSA 50032 31059 Toulouse Cédex 9,France%INSERM U563,IFR 30,CHU Purpan,TSA 50032 31059 Toulouse Cédex 9,France</publisher><subject>ABO Blood-Group System - immunology ; ABO血型 ; Adult ; Antibodies, Monoclonal - therapeutic use ; Antibodies, Monoclonal, Murine-Derived ; Blood Group Incompatibility - immunology ; Blood Group Incompatibility - therapy ; Case Report ; Female ; Graft Rejection - immunology ; Graft Rejection - pathology ; Graft Rejection - therapy ; Humans ; Immunologic Factors - therapeutic use ; Liver Transplantation - adverse effects ; Middle Aged ; Plasmapheresis ; Rituximab ; Treatment Outcome ; 肝移植</subject><ispartof>World journal of gastroenterology : WJG, 2009-07, Vol.15 (27), p.3426-3430</ispartof><rights>Copyright © Wanfang Data Co. Ltd. All Rights Reserved.</rights><rights>2009 The WJG Press and Baishideng. All rights reserved. 2009</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c501t-12662096f0d5e55e7575cb3053f1dd51d7eea4fc6c413855a7232c3025674e213</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Uhttp://image.cqvip.com/vip1000/qk/84123X/84123X.jpg</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2712906/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2712906/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,729,782,786,887,27931,27932,53798,53800</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19610146$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kamar, Nassim</creatorcontrib><creatorcontrib>Lavayssière, Laurence</creatorcontrib><creatorcontrib>Muscari, Fabrice</creatorcontrib><creatorcontrib>Selves, Janick</creatorcontrib><creatorcontrib>Guilbeau-Frugier, Céline</creatorcontrib><creatorcontrib>Cardeau, Isabelle</creatorcontrib><creatorcontrib>Esposito, Laure</creatorcontrib><creatorcontrib>Cointault, Olivier</creatorcontrib><creatorcontrib>Nogier, Marie Béatrice</creatorcontrib><creatorcontrib>Peron, Jean Marie</creatorcontrib><creatorcontrib>Otal, Philippe</creatorcontrib><creatorcontrib>Fort, Marylise</creatorcontrib><creatorcontrib>Rostaing, Lionel</creatorcontrib><title>Early plasmapheresis and rituximab for acute humoral rejection after ABO-compatible liver transplantation</title><title>World journal of gastroenterology : WJG</title><addtitle>World Journal of Gastroenterology</addtitle><description>Acute humoral rejection （AHR） is uncommon after ABO- compatible liver transplantation. Herein, we report two cases of AHR treated with plasmapheresis and rituximab in two ABO-compatible liver-transplant patients with preformed anti-human leukocyte antigen donor-specific antibodies. Patient 1 experienced a biopsy-proven AHR at day 10 post-transplant. She was treated by steroid pulses, and OKT3. Because of persisting signs of biopsy-proven AHR at day 26, she was treated by plasmapheresis and rituximab. Uver enzyme levels did not improve, and she died on day 41. Patient 2 experienced a biopsy-proven AHR on day 10 post-transplant. She was treated by steroid pulses, plasmapheresis, and rituximab. Liver enzymes returned to within normal range 18 d after diagnosis. Uver biopsies, at 3 and 9 mo post-transplant, showed complete resolution of AHR. We conclude that plasmapheresis should be started as soon as AHR is diagnosed, and be associated with a B-cell depleting agent. Rituximab may be considered as a first-line therapy.</description><subject>ABO Blood-Group System - immunology</subject><subject>ABO血型</subject><subject>Adult</subject><subject>Antibodies, Monoclonal - therapeutic use</subject><subject>Antibodies, Monoclonal, Murine-Derived</subject><subject>Blood Group Incompatibility - immunology</subject><subject>Blood Group Incompatibility - therapy</subject><subject>Case Report</subject><subject>Female</subject><subject>Graft Rejection - immunology</subject><subject>Graft Rejection - pathology</subject><subject>Graft Rejection - therapy</subject><subject>Humans</subject><subject>Immunologic Factors - therapeutic use</subject><subject>Liver Transplantation - adverse effects</subject><subject>Middle Aged</subject><subject>Plasmapheresis</subject><subject>Rituximab</subject><subject>Treatment Outcome</subject><subject>肝移植</subject><issn>1007-9327</issn><issn>2219-2840</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkUtv1DAURi0EokNhxR5ZCLFBGezrOB5vKpWqPKRK3cDacpybGQ-JndpJS_89Hs2Ix8qSffT53PsR8pqztVD15uPDfrvmci1qaJ6QFQDXFWxq9pSsOGOq0gLUGXmR854xEELCc3LGdcMZr5sV8dc2DY90Gmwe7bTDhNlnakNHk5-XX360Le1jotYtM9LdMsZkB5pwj272MVDbz5jo5afbysVxsrNvB6SDvy-Xc7Ihl-Aw2wP6kjzr7ZDx1ek8Jz8-X3-_-lrd3H75dnV5UznJ-FxxaBpguulZJ1FKVFJJ1womRc-7TvJOIdq6d42rudhIaRUIcIKBbFSNwMU5uTjmTks7YucwFJHBTKnMkh5NtN78_xL8zmzjvQHFQbOmBLw7BjzY0NuwNfu4pFCUTdk0MKZBld0V7P3pnxTvFsyzGX12OJSBMS7ZFB2tN1oV8MMRdCnmnLD_48KZOTR4yDVcmkODhX7zr_5f9lRZAd6e4nYxbO98EWyt-9n7AY3gUEOtufgNZIqj_Q</recordid><startdate>20090721</startdate><enddate>20090721</enddate><creator>Kamar, Nassim</creator><creator>Lavayssière, Laurence</creator><creator>Muscari, Fabrice</creator><creator>Selves, Janick</creator><creator>Guilbeau-Frugier, Céline</creator><creator>Cardeau, Isabelle</creator><creator>Esposito, Laure</creator><creator>Cointault, Olivier</creator><creator>Nogier, Marie Béatrice</creator><creator>Peron, Jean Marie</creator><creator>Otal, Philippe</creator><creator>Fort, Marylise</creator><creator>Rostaing, Lionel</creator><general>INSERM U858,IFR 31,CHU Rangueil,TSA 50032 31059 Toulouse Cédex 9,France%Department of Nephrology,Dialysis and Multi-Organ Transplantation,CHU Rangueil,TSA 50032 31059 Toulouse Cedex 9,France%Department of Liver Transplantation,CHU Rangueil,TSA 50032 31059 Toulouse Cédex 9,France%Department of Histopathology,CHU Purpan,TSA 50032 31059 Toulouse Cédex 9,France%Department of Histopathology,CHU Rangueil,TSA 50032 31059 Toulouse Cédex 9,France%Department of Hepatology,CHU Purpan,TSA 50032 31059 Toulouse Cédex 9,France%Department of Radiology,CHU Rangueil,TSA 50032 31059 Toulouse Cédex 9,France%Department of Immunology,CHU Rangueil,TSA 50032 31059 Toulouse Cédex 9,France%INSERM U563,IFR 30,CHU Purpan,TSA 50032 31059 Toulouse Cédex 9,France</general><general>The WJG Press</general><scope>2RA</scope><scope>92L</scope><scope>CQIGP</scope><scope>W94</scope><scope>WU4</scope><scope>~WA</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>2B.</scope><scope>4A8</scope><scope>92I</scope><scope>93N</scope><scope>PSX</scope><scope>TCJ</scope><scope>5PM</scope></search><sort><creationdate>20090721</creationdate><title>Early plasmapheresis and rituximab for acute humoral rejection after ABO-compatible liver transplantation</title><author>Kamar, Nassim ; 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Herein, we report two cases of AHR treated with plasmapheresis and rituximab in two ABO-compatible liver-transplant patients with preformed anti-human leukocyte antigen donor-specific antibodies. Patient 1 experienced a biopsy-proven AHR at day 10 post-transplant. She was treated by steroid pulses, and OKT3. Because of persisting signs of biopsy-proven AHR at day 26, she was treated by plasmapheresis and rituximab. Uver enzyme levels did not improve, and she died on day 41. Patient 2 experienced a biopsy-proven AHR on day 10 post-transplant. She was treated by steroid pulses, plasmapheresis, and rituximab. Liver enzymes returned to within normal range 18 d after diagnosis. Uver biopsies, at 3 and 9 mo post-transplant, showed complete resolution of AHR. We conclude that plasmapheresis should be started as soon as AHR is diagnosed, and be associated with a B-cell depleting agent. Rituximab may be considered as a first-line therapy.</abstract><cop>United States</cop><pub>INSERM U858,IFR 31,CHU Rangueil,TSA 50032 31059 Toulouse Cédex 9,France%Department of Nephrology,Dialysis and Multi-Organ Transplantation,CHU Rangueil,TSA 50032 31059 Toulouse Cedex 9,France%Department of Liver Transplantation,CHU Rangueil,TSA 50032 31059 Toulouse Cédex 9,France%Department of Histopathology,CHU Purpan,TSA 50032 31059 Toulouse Cédex 9,France%Department of Histopathology,CHU Rangueil,TSA 50032 31059 Toulouse Cédex 9,France%Department of Hepatology,CHU Purpan,TSA 50032 31059 Toulouse Cédex 9,France%Department of Radiology,CHU Rangueil,TSA 50032 31059 Toulouse Cédex 9,France%Department of Immunology,CHU Rangueil,TSA 50032 31059 Toulouse Cédex 9,France%INSERM U563,IFR 30,CHU Purpan,TSA 50032 31059 Toulouse Cédex 9,France</pub><pmid>19610146</pmid><doi>10.3748/wjg.15.3426</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1007-9327 |
| ispartof | World journal of gastroenterology : WJG, 2009-07, Vol.15 (27), p.3426-3430 |
| issn | 1007-9327 2219-2840 |
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| source | MEDLINE; Baishideng "World Journal of" online journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | ABO Blood-Group System - immunology ABO血型 Adult Antibodies, Monoclonal - therapeutic use Antibodies, Monoclonal, Murine-Derived Blood Group Incompatibility - immunology Blood Group Incompatibility - therapy Case Report Female Graft Rejection - immunology Graft Rejection - pathology Graft Rejection - therapy Humans Immunologic Factors - therapeutic use Liver Transplantation - adverse effects Middle Aged Plasmapheresis Rituximab Treatment Outcome 肝移植 |
| title | Early plasmapheresis and rituximab for acute humoral rejection after ABO-compatible liver transplantation |
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