The effect of combination therapy with rituximab and intravenous immunoglobulin on the progression of chronic antibody mediated rejection in renal transplant recipients

Gun H ee An, Jintak Yun, Yu A h Hong, Marina Khvan, Byung H a Chung, Bum S oon Choi, Cheol W hee Park, Yeong J in Choi, Yong Soo Kim, Chul W oo Yang

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Abstract

The treatment for chronic active antibody-mediated rejection (CAMR) remains controversial. We investigated the efficacy of rituximab (RTX) and intravenous immunoglobulin (IVIg) for CAMR. Eighteen patients with CAMR were treated with RTX (375 mg/m(2)) and IVIg (0.4 g/kg) for 4 days. The efficacy of RTX/IVIg combination therapy (RIT) was assessed by decline in estimated glomerular filtration rate per month (ΔeGFR) before and after RIT. Patients were divided into responder and nonresponder groups based on decrease and no decrease in ΔeGFR, respectively, and their clinical and histological characteristics were compared. Response rate to RIT was 66.7% (12/18), and overall ΔeGFR decreased significantly to 0.4 ± 1.7 mL·min(-1) ·1.73 m(-2) per month 6 months after RIT compared to that observed 6 months before RIT (1.8 ± 1.0, P <0.05). Clinical and histological features between the 12 responders and the 6 nonresponders were not significantly different, but nonresponders had a significantly higher proteinuria levels at the time of RIT (2.5 ± 2.5 versus 7.0 ± 3.5 protein/creatinine (g/g), P <0.001). The effect of the RIT on ΔeGFR had dissipated in all patients by 1 year post-RIT. Thus, RIT delayed CAMR progression, and baseline proteinuria level was a prognostic factor for response to RIT.

LanguageEnglish
Pages828732
Number of pages1
JournalJournal of Immunology Research
Volume2014
DOIs
Publication statusPublished - 2014
Externally publishedYes

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Intravenous Immunoglobulins
Kidney
Antibodies
Therapeutics
Proteinuria
Rituximab
Transplant Recipients
Passive Immunization
Glomerular Filtration Rate
Creatinine

ASJC Scopus subject areas

  • Medicine(all)

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The effect of combination therapy with rituximab and intravenous immunoglobulin on the progression of chronic antibody mediated rejection in renal transplant recipients. / An, Gun H ee; Yun, Jintak; Hong, Yu A h; Khvan, Marina; Chung, Byung H a; Choi, Bum S oon; Park, Cheol W hee; Choi, Yeong J in; Kim, Yong Soo; Yang, Chul W oo.

In: Journal of Immunology Research, Vol. 2014, 2014, p. 828732.

Research output: Contribution to journalArticle

An, Gun H ee ; Yun, Jintak ; Hong, Yu A h ; Khvan, Marina ; Chung, Byung H a ; Choi, Bum S oon ; Park, Cheol W hee ; Choi, Yeong J in ; Kim, Yong Soo ; Yang, Chul W oo. / The effect of combination therapy with rituximab and intravenous immunoglobulin on the progression of chronic antibody mediated rejection in renal transplant recipients. In: Journal of Immunology Research. 2014 ; Vol. 2014. pp. 828732.
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