Aranda Juan M, Scornik Juan C, Normann Sigurd J, Lottenberg Richard, Schofield Richard S, Pauly Daniel F, Miles Maureen, Hill James A, Sleasman John W, Skoda-Smith Suzanne
Department of Medicine, Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA.
Transplantation. 2002 Mar 27;73(6):907-10. doi: 10.1097/00007890-200203270-00013.
Humoral or antibody-mediated rejection in cardiac transplant recipients is mediated by donor-specific cytotoxic antibodies and is histologically defined by linear deposits of immunoglobulin and complement in the myocardial capillaries. Antibody-mediated rejection often is accompanied by hemodynamic compromise and is associated with reduced long-term graft survival. Standard immunosuppression, designed to target T cell immune function, is largely ineffective against this B cell-driven process. Current treatment options for humoral rejection are limited by a lack of specific anti-B cell therapies. We present the case of a 50-year-old woman with hemodynamically significant humoral rejection resistant to steroids, cyclophos-phamide, and plasmapheresis who responded to the addition of anti-CD20 monoclonal antibody therapy (rituximab). One year posttransplant, the patient is rejection-free, with normal left ventricular systolic function and coronary arteries.
