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Early plasmapheresis and rituximab for acute humoral rejection after ABO-compatible liver transplantation 被引量:8
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作者 Nassim Kamar Laurence Lavayssière +10 位作者 Fabrice Muscari Janick Selves Céline Guilbeau-Frugier isabelle cardeau Laure Esposito Olivier Cointault Marie Béatrice Nogier Jean Marie Peron Philippe Otal Marylise Fort Lionel Rostaing 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第27期3426-3430,共5页
Acute humoral rejection (AHR) is uncommon after ABO- compatible liver transplantation. Herein, we report two cases of AHR treated with plasmapheresis and rituximab in two ABO-compatible liver-transplant patients wit... Acute humoral rejection (AHR) is uncommon after ABO- compatible liver transplantation. Herein, we report two cases of AHR treated with plasmapheresis and rituximab in two ABO-compatible liver-transplant patients with preformed anti-human leukocyte antigen donor-specific antibodies. Patient 1 experienced a biopsy-proven AHR at day 10 post-transplant. She was treated by steroid pulses, and OKT3. Because of persisting signs of biopsy-proven AHR at day 26, she was treated by plasmapheresis and rituximab. Uver enzyme levels did not improve, and she died on day 41. Patient 2 experienced a biopsy-proven AHR on day 10 post-transplant. She was treated by steroid pulses, plasmapheresis, and rituximab. Liver enzymes returned to within normal range 18 d after diagnosis. Uver biopsies, at 3 and 9 mo post-transplant, showed complete resolution of AHR. We conclude that plasmapheresis should be started as soon as AHR is diagnosed, and be associated with a B-cell depleting agent. Rituximab may be considered as a first-line therapy. 展开更多
关键词 Acute humoral rejection Liver transplantation Donor-specific antibodies RITUXIMAB PLASMAPHERESIS
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