title: [Multimodal treatment for acute antibody-mediated renal transplant rejection: successful rescue therapy with combined plasmapheresis, photopheresis and intravenous immunoglobulin].
abstract: The fundamental role of antibodies in the development of acute graft rejection has been established recently. Antibody-mediated acute rejection may develop at any time during the post-transplant period. Several therapeutic approaches have been proposed in the last decades. However, there is no standardized therapy. The aim of this study is to report the Sapienza University experience of combined plasma treatment and high-dose intravenous immunoglobulin ± extracorporeal photopheresis. From January 2006 to September 2009, 6 patients were treated at Sapienza University. In 5 cases (83%) complete regression of the acute rejection was observed, followed by stable renal function (median creatinine value at 1-year follow-up: 1.5 mg/dL). No adverse events were reported. Our approach seems to give good results in terms of graft survival and procedure safety. Further studies on a larger number of patients will be needed to confirm the validity of these findings. Moreover, comparison between our protocol and other treatments is necessary.
authors.affiliation: Sapienza Universita' di Roma, Roma, Italy. lai.quirino@libero.it
authors.forename: Quirino
authors.initials: Q
authors.lastname: Lai
authors.forename: Renzo
authors.initials: R
authors.lastname: Pretagostini
authors.forename: Maria
authors.initials: M
authors.lastname: Gozzer
authors.forename: Paola
authors.initials: P
authors.lastname: Cinti
authors.forename: Donatella
authors.initials: D
authors.lastname: Meo
authors.forename: Fabiana
authors.initials: F
authors.lastname: Vita
authors.forename: Manas Shafii
authors.initials: MS
authors.lastname: Bafti
authors.forename: Luca
authors.initials: L
authors.lastname: Poli
authors.forename: Gilnardo
authors.initials: G
authors.lastname: Novelli
authors.forename: Massimo
authors.initials: M
authors.lastname: Rossi
authors.forename: Gabriella
authors.initials: G
authors.lastname: Girelli
authors.forename: Pasquale B
authors.initials: PB
authors.lastname: Berloco
mesh_terms: D000208:Acute Disease; D000328:Adult; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control / Q000628:therapy*; D006085:Graft Survival; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D017893:Photopheresis; D010956:Plasmapheresis / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous