Iwai Tomoaki, Uchida Junji, Kabei Kazuya, Nishide Shunji, Kuwabara Nobuyuki, Naganuma Toshihide, Kumada Norihiko, Takemoto Yoshiaki, Nakatani Tatsuya
From the Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
Exp Clin Transplant. 2019 Oct;17(5):678-680. doi: 10.6002/ect.2017.0062. Epub 2017 Nov 15.
We report an ABO-incompatible kidney transplant performed on a 69-year-old female patient, whose donor was her 69-year-old husband. The patient received an immunosuppressive protocol using rituximab without splenectomy. Renal biopsy was done on posttransplant day 8 due to poor early graft function, and an isolated v-lesion was found, which responded to steroid pulse therapy and gusperimus hydrochloride administration. Our results indicate that isolated v-lesions can occur in ABO-incompatible kidney transplant recipients receiving rituximab and that this finding should be treated as acute rejection. To our knowledge, this is the first report of an isolated v-lesion in an ABO-incompatible kidney transplant recipient who had been administered rituximab.
我们报告了一例在一名69岁女性患者身上进行的ABO血型不相容肾移植手术，其供体为她69岁的丈夫。该患者接受了使用利妥昔单抗且未行脾切除术的免疫抑制方案。由于早期移植肾功能不佳，在移植后第8天进行了肾活检，发现了孤立性v病变，该病变对类固醇冲击疗法和盐酸胍立莫司给药有反应。我们的结果表明，接受利妥昔单抗治疗的ABO血型不相容肾移植受者可能会出现孤立性v病变，并且这一发现应被视为急性排斥反应。据我们所知，这是关于接受利妥昔单抗治疗的ABO血型不相容肾移植受者出现孤立性v病变的首例报告。
