Acute antibody-mediated rejection in pediatric kidney transplants: A single center experience

被引:18
|
作者
Twombley, Katherine [1 ]
Thach, Lonnie [2 ,3 ]
Ribeiro, Annelise [2 ,3 ]
Joseph, Catherine [2 ,3 ]
Seikaly, Mouin [2 ,3 ]
机构
[1] Med Univ S Carolina, Dept Pediat, Charleston, SC 29435 USA
[2] Univ Texas SW Med Ctr Dallas, Dept Pediat, Dallas, TX 75390 USA
[3] Childrens Med Ctr Dallas, Dallas, TX USA
关键词
adolescents; antibodies; antibody mediated rejection; anti-HLA antibody; pediatric kidney transplant; outcome; RENAL-ALLOGRAFT REJECTION; ACUTE HUMORAL REJECTION; RABBIT ANTITHYMOCYTE GLOBULIN; UNFOLDED PROTEIN RESPONSE; B-CELL; PROTEASOME INHIBITION; PLASMA-CELLS; MONOCLONAL-ANTIBODY; RITUXIMAB THERAPY; BORTEZOMIB;
D O I
10.1111/petr.12129
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
aAMR is a potentially devastating complication of kidney transplantation. The incidence of aAMR in children, while thought to be rare, is not well defined, and there is a paucity of data on treatment regimens in children. We retrospectively reviewed the outcomes of our pediatric patients that were treated for aAMR between 2007 and 2009. Three adolescent Hispanic males were found to have aAMR. All three received deceased donor transplants, and all three verbalized non-adherence. Treatment consisted of rituximab, solumedrol, PE, and IVIgG in one patient, and PE, IVIgG, and bortezomib in two patients. The only side effect of therapy noted was mild hypotension with rituximab that resolved after decreasing the infusion rate. There were no reported infections two yr after treatment, and all of the viral monitoring in these patients remained negative.
引用
收藏
页码:E149 / E155
页数:7
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