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10.1371/journal.pone.0178572

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suck abstract from ncbi


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pmid28654684      PLoS+One 2017 ; 12 (6): ä
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  • Intravenous immunoglobulin therapy in kidney transplant recipients with de novo DSA: Results of an observational study #MMPMID28654684
  • Matignon M; Pilon C; Commereuc M; Grondin C; Leibler C; Kofman T; Audard V; Cohen J; Canoui-Poitrine F; Grimbert P
  • PLoS One 2017[]; 12 (6): ä PMID28654684show ga
  • Background: Approximately 25% of kidney transplant recipients develop de novo anti-HLA donor-specific antibodies (dnDSA) leading to acute antibody-mediated rejection (ABMR) in 30% of patients. Preemptive therapeutic strategies are not available. Methods: We conducted a prospective observational study including 11 kidney transplant recipients. Inclusion criteria were dnDSA occurring within the first year after transplant and normal allograft biopsy. All patients were treated with high-dose IVIG (2 g/kg 0, 1 and 2 months post-dnDSA). The primary efficacy outcome was incidence of clinical and subclinical acute ABMR within 12 months after dnDSA detection as compared to a historical control group (IVIG-). Results: Acute ABMR occurred in 2 or 11 patients in the IVIG+ group and in 1 of 9 patients in the IVIG- group. IVIG treatment did not affect either class I or class II DSA, as observed at the end of the follow-up. IVIG treatment significantly decreased Fc?RIIA mRNA expression in circulating leukocytes, but did not affect the expression of any other markers of B cell activation. Conclusions: In this first pilot study including kidney allograft recipients with early dnDSA, preemptive treatment with high-dose IVIG alone did not prevent acute ABMR and had minimal effects on DSA outcome and B cell phenotype.
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