title: Renal Allograft Failure After Ipilimumab Therapy for Metastatic Melanoma: A Case Report and Review of the Literature.
abstract: Transplant recipients are at an increased risk of malignant melanoma, a result of chronic immunosuppression. Ipilimumab is a newer biological agent targeting T lymphocytes to potentiate an immune response against melanoma, and the use of this agent results in a new adverse effect profile that the clinician must be aware of while a patient is on therapy. We report the case of a male renal transplant recipient who developed graft failure while treated with ipilimumab and minimal immunosuppressive therapy for metastatic ocular melanoma, with biopsy evidence of glomerulonephritis and acute rejection. We highlight the immunological side effects that can manifest from ipilimumab therapy and conclude that it did influence graft function in this patient. Our case illustrates the importance of weighing the risks and benefits to graft function and long-term survival as well as the importance of considering other treatment modalities in this specific group of melanoma patients.
authors.affiliation: Department of Transplant Surgery, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom; University of Manchester, Manchester, United Kingdom. Electronic address: a.jose@doctors.org.uk.
authors.forename: A
authors.initials: A
authors.lastname: Jose
authors.affiliation: Department of Transplant Surgery, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: P
authors.initials: P
authors.lastname: Yiannoullou
authors.affiliation: Department of Nephrology, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: S
authors.initials: S
authors.lastname: Bhutani
authors.affiliation: Department of Histopathology, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: H
authors.initials: H
authors.lastname: Denley
authors.affiliation: Department of Nephrology, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Morton
authors.affiliation: Department of Nephrology, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Picton
authors.affiliation: Department of Transplant Surgery, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Summers
authors.affiliation: Department of Transplant Surgery, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom; University of Manchester, Manchester, United Kingdom.
authors.forename: D
authors.initials: D
authors.lastname: van Dellen
authors.affiliation: Department of Transplant Surgery, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom; University of Manchester, Manchester, United Kingdom.
authors.forename: T
authors.initials: T
authors.lastname: Augustine
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D006084:Graft Rejection / Q000139:chemically induced* / Q000276:immunology; D006801:Humans; D000074324:Ipilimumab; D007668:Kidney / Q000276:immunology; D016030:Kidney Transplantation; D008297:Male; D008545:Melanoma / Q000188:drug therapy*; D008875:Middle Aged; D051437:Renal Insufficiency / Q000139:chemically induced; D014184:Transplantation, Homologous; D014604:Uveal Neoplasms / Q000188:drug therapy*; D000098943:Uveal Melanoma
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D000074324:Ipilimumab