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Information Journal Paper

Title

Comparing Plasmapheresis plus IVIg with Plasmapheresis plus IVIg plus Rituximab on the Management of Suspicious Antibody-Mediated Acute Rejection in Kidney Transplant Recipients

Pages

  127-136

Abstract

 Background: There is no treatment of choice for the management of acute antibody-mediated rejection (ABMR) in kidney transplant recipients. Plasmapheresis ± Intravenous immunoglobulin (IVIg) ± Rituximab has been used in different regimens with contradictory results. Objective: To compare three regimens of acute ABMR management including Plasmapheresis + IVIg ± Rituximab in two different Rituximab regimens. Methods: In this prospective, observational study kidney transplant recipients with suspicious ABMR were categorized into three groups. Group 1 patients were treated with Plasmapheresis + IVIg. Groups 2 and 3 received weekly Rituximab at a dosage of 375 mg/m2 for either 4 doses (group 2 or high dose) or 2 doses (group 3 or low dose) in addition to Plasmapheresis + IVIg. Results: 8, 15, and 9 patients were categorized in groups 1, 2, and 3, respectively. There was no difference among the groups in terms of demographic and clinical characteristics of recipients and donors. Although, 1-year graft (37. 5%, 60. 0%, and 66. 7% for groups 1, 2, and 3, respectively; p=0. 308) and patients survival (75. 0%, 86. 7%, and 77. 8% for groups 1, 2, and 3, respectively; p=0. 730) were not significantly different among studied groups, graft survival was 22%– 30% higher in Rituximab-treated groups. Estimated glomerular filtration rate at 12th month of follow-up did not differ among groups (56. 3± 19. 6, 57. 3± 20. 6, 48. 7± 16. 1 mL/min/1. 73 m2 for groups 1, 2, and 3, respectively; p=0. 683). However, kidney function steadily improved over time in Rituximab-treated patients. Conclusion: Adding high or low doses of Rituximab to Plasmapheresis + IVIg comparably increased graft survival in suspicious acute ABMR kidney recipients and steadily improved kidney function among survived allografts over time.

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    APA: Copy

    AHMADI, F., DASHTI KHAVIDAKI, S., KHATAMI, M.R., Gatmiri, M., AHMADI, F., MAHDAVI MAZDEH, M., Najafi, m.t., FOROOZANFAR, Z., MAHDIZADEH, A., & DERAFSHI, S.. (2019). Comparing Plasmapheresis plus IVIg with Plasmapheresis plus IVIg plus Rituximab on the Management of Suspicious Antibody-Mediated Acute Rejection in Kidney Transplant Recipients. INTERNATIONAL JOURNAL OF ORGAN TRANSPLANTATION MEDICINE, 10(3), 127-136. SID. https://sid.ir/paper/751285/en

    Vancouver: Copy

    AHMADI F., DASHTI KHAVIDAKI S., KHATAMI M.R., Gatmiri M., AHMADI F., MAHDAVI MAZDEH M., Najafi m.t., FOROOZANFAR Z., MAHDIZADEH A., DERAFSHI S.. Comparing Plasmapheresis plus IVIg with Plasmapheresis plus IVIg plus Rituximab on the Management of Suspicious Antibody-Mediated Acute Rejection in Kidney Transplant Recipients. INTERNATIONAL JOURNAL OF ORGAN TRANSPLANTATION MEDICINE[Internet]. 2019;10(3):127-136. Available from: https://sid.ir/paper/751285/en

    IEEE: Copy

    F. AHMADI, S. DASHTI KHAVIDAKI, M.R. KHATAMI, M. Gatmiri, F. AHMADI, M. MAHDAVI MAZDEH, m.t. Najafi, Z. FOROOZANFAR, A. MAHDIZADEH, and S. DERAFSHI, “Comparing Plasmapheresis plus IVIg with Plasmapheresis plus IVIg plus Rituximab on the Management of Suspicious Antibody-Mediated Acute Rejection in Kidney Transplant Recipients,” INTERNATIONAL JOURNAL OF ORGAN TRANSPLANTATION MEDICINE, vol. 10, no. 3, pp. 127–136, 2019, [Online]. Available: https://sid.ir/paper/751285/en

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