Department of Clinical Immunology, Odense University Hospital, Odense, Denmark.
Nephrol Dial Transplant. 2010 Jan;25(1):310-3. doi: 10.1093/ndt/gfp527. Epub 2009 Oct 9.
ABO-incompatible kidney transplantation is possible after pre-treatment with rituximab, intravenous immunoglobulin and basiliximab combined with tacrolimus, mycophenolate mofetil and prednisolone. We report on the first patient treated with this protocol who developed acute antibody-mediated rejection (Banff grade II with IgG deposits) caused by ABO antibodies (anti-B). Anti-rejection treatment with anti-B-specific immunoadsorption, intravenous immunoglobulin and methylprednisolone efficiently cleared deposited IgG from the kidney allograft and re-established normal kidney function. We suggest that ABO-incompatible kidney transplantation complicated by acute antibody-mediated rejection, caused by ABO antibodies, may successfully be treated with this regime.
ABO 不相容的肾移植在利妥昔单抗、静脉注射免疫球蛋白和巴利昔单抗联合他克莫司、霉酚酸酯和泼尼松龙预处理后成为可能。我们报告了首例接受该方案治疗的患者，该患者发生了由 ABO 抗体（抗-B）引起的急性抗体介导的排斥反应（Banff 分级 II 伴有 IgG 沉积）。抗-B 特异性免疫吸附、静脉注射免疫球蛋白和甲基强的松龙的抗排斥治疗有效地从肾移植中清除了沉积的 IgG，恢复了正常的肾功能。我们建议，由 ABO 抗体引起的 ABO 不相容肾移植合并急性抗体介导的排斥反应，可以通过该方案成功治疗。
