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Beneficial effect of plasmapheresis and intravenous immunoglobulin on renal allograft survival of patients with acute humoral rejection.

Publication ,  Journal Article
Rocha, PN; Butterly, DW; Greenberg, A; Reddan, DN; Tuttle-Newhall, J; Collins, BH; Kuo, PC; Reinsmoen, N; Fields, T; Howell, DN; Smith, SR
Published in: Transplantation
May 15, 2003

BACKGROUND: Acute humoral rejection (AHR) has been associated with enhanced graft loss. Our study compared the renal allograft survival of patients with AHR treated with plasmapheresis (PP) and intravenous immunoglobulin (IVIG) with allograft survival in patients with acute cellular rejection (ACR). METHODS: We retrospectively analyzed all kidney transplants performed at our institution between January 1999 and August 2001 (n=286). Recipients were classified into three groups according to biopsy reports: AHR, ACR, or no rejection. The ACR group was further divided into early and late rejection (<90 and >90 days posttransplant, respectively). RESULTS: After a mean follow-up of 569+/-19 days, the incidence of AHR was 5.6% (n=16). Recipient presensitization, delayed graft function, early rejection, and higher creatinine at diagnosis were characteristic of AHR. Most AHR patients (14/16) were treated with PP and IVIG. One patient received only IVIG, whereas another received only PP. All AHR patients were given steroid pulses, but only four received antilymphocyte therapy because of concomitant severe ACR. The ACR group comprised 43 patients (15%). One patient with mild rejection received no therapy, 20 improved with steroids alone, and 22 required additional antilymphocyte therapy. One-year graft survival by Kaplan Meier analysis was 81% and 84% in the AHR and ACR groups, respectively (P=NS). Outcomes remained similar when AHR patients were compared with those with early ACR. CONCLUSIONS: We conclude that AHR, when diagnosed early and treated aggressively with PP and IVIG, carries a short-term prognosis that is similar to ACR.

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Published In

Transplantation

DOI

ISSN

0041-1337

Publication Date

May 15, 2003

Volume

75

Issue

9

Start / End Page

1490 / 1495

Location

United States

Related Subject Headings

  • Transplantation, Homologous
  • Surgery
  • Retrospective Studies
  • Plasmapheresis
  • Middle Aged
  • Male
  • Kidney Transplantation
  • Immunoglobulins, Intravenous
  • Humans
  • HLA Antigens
 

Citation

APA
Chicago
ICMJE
MLA
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Rocha, P. N., Butterly, D. W., Greenberg, A., Reddan, D. N., Tuttle-Newhall, J., Collins, B. H., … Smith, S. R. (2003). Beneficial effect of plasmapheresis and intravenous immunoglobulin on renal allograft survival of patients with acute humoral rejection. Transplantation, 75(9), 1490–1495. https://doi.org/10.1097/01.TP.0000060252.57111.AC
Rocha, Paulo N., David W. Butterly, Arthur Greenberg, Donal N. Reddan, Janet Tuttle-Newhall, Bradley H. Collins, Paul C. Kuo, et al. “Beneficial effect of plasmapheresis and intravenous immunoglobulin on renal allograft survival of patients with acute humoral rejection.Transplantation 75, no. 9 (May 15, 2003): 1490–95. https://doi.org/10.1097/01.TP.0000060252.57111.AC.
Rocha PN, Butterly DW, Greenberg A, Reddan DN, Tuttle-Newhall J, Collins BH, et al. Beneficial effect of plasmapheresis and intravenous immunoglobulin on renal allograft survival of patients with acute humoral rejection. Transplantation. 2003 May 15;75(9):1490–5.
Rocha, Paulo N., et al. “Beneficial effect of plasmapheresis and intravenous immunoglobulin on renal allograft survival of patients with acute humoral rejection.Transplantation, vol. 75, no. 9, May 2003, pp. 1490–95. Pubmed, doi:10.1097/01.TP.0000060252.57111.AC.
Rocha PN, Butterly DW, Greenberg A, Reddan DN, Tuttle-Newhall J, Collins BH, Kuo PC, Reinsmoen N, Fields T, Howell DN, Smith SR. Beneficial effect of plasmapheresis and intravenous immunoglobulin on renal allograft survival of patients with acute humoral rejection. Transplantation. 2003 May 15;75(9):1490–1495.

Published In

Transplantation

DOI

ISSN

0041-1337

Publication Date

May 15, 2003

Volume

75

Issue

9

Start / End Page

1490 / 1495

Location

United States

Related Subject Headings

  • Transplantation, Homologous
  • Surgery
  • Retrospective Studies
  • Plasmapheresis
  • Middle Aged
  • Male
  • Kidney Transplantation
  • Immunoglobulins, Intravenous
  • Humans
  • HLA Antigens