Four-year allograft survival in a highly sensitized combined liver-kidney transplant patient despite unsuccessful anti-HLA antibody reduction with rituximab, splenectomy, and bortezomib.
Transpl Int
; 26(8): e64-8, 2013 Aug.
Article
in En
| MEDLINE
| ID: mdl-23672514
ABSTRACT
Although donor-specific lymphocytotoxic antibodies are regarded as a contraindication for kidney transplantation (KTx), the data available for liver or combined liver or kidney transplantation (cLKTx) are scarce. Here, we report a case of a highly sensitized young man receiving his sixth liver and second kidney graft. Multiple anti-HLA antibodies were present at the time of transplantation. As a result of suspected antibody-mediated graft damage, the patient was treated with rituximab, plasmapheresis, intravenous immunoglobulins, splenectomy, and bortezomib to decrease the antibody production. So far, patient and allograft survival has reached 4 years despite failure to achieve a permanent reduction of anti-HLA antibodies, and particularly nondonor directed antibodies.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pyrazines
/
Boronic Acids
/
Kidney Transplantation
/
Liver Transplantation
/
Antibodies, Monoclonal, Murine-Derived
/
Graft Survival
/
HLA Antigens
Limits:
Adult
/
Humans
/
Male
Language:
En
Journal:
Transpl Int
Journal subject:
TRANSPLANTE
Year:
2013
Document type:
Article
Affiliation country:
Alemania