Immunoadsorbtion and rituximab therapy in a second living-related kidney transplant patient with recurrent focal segmental glomerulosclerosis.
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Immunoadsorbtion and rituximab therapy in a second living-related kidney transplant patient with recurrent focal segmental glomerulosclerosis. / Meyer, Tobias; Thaiss, Friedrich; Stahl, Rolf A.K.
In: TRANSPL INT, Vol. 20, No. 12, 12, 2007, p. 1066-1071.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Immunoadsorbtion and rituximab therapy in a second living-related kidney transplant patient with recurrent focal segmental glomerulosclerosis.
AU - Meyer, Tobias
AU - Thaiss, Friedrich
AU - Stahl, Rolf A.K.
PY - 2007
Y1 - 2007
N2 - A 29-year-old patient with focal segmental glomerulosclerosis (FSGS) and recurrence of the disease in a living donor kidney transplant received a second living-related kidney graft. She received pre- and postoperative immunoadsorptions and immunosuppression with tacrolimus, mycophenolate mofetil, basiliximab and steroids. Serum creatinine returned to normal values and only minor proteinuria was detected post-transplant (400 mg/24 h). However, recurrence of proteinuria with up to 3.3 g/24 h occurred 2 months after transplantation and the patient underwent intermediate immunoadsorption sessions with immediate reduction of proteinuria for the following year. She then received three doses of rituximab (600 mg, 375 mg/m(2)) that caused immediate reduction of proteinuria with only minimal increase in the following 12 months. Graft function is excellent 2 years after transplantation. These findings suggest that intermittent immunoadsorption combined with B-cell depletion by rituximab treatment induced prolonged reduction of proteinuria in a high-risk patient for recurrence of FSGS in the graft.
AB - A 29-year-old patient with focal segmental glomerulosclerosis (FSGS) and recurrence of the disease in a living donor kidney transplant received a second living-related kidney graft. She received pre- and postoperative immunoadsorptions and immunosuppression with tacrolimus, mycophenolate mofetil, basiliximab and steroids. Serum creatinine returned to normal values and only minor proteinuria was detected post-transplant (400 mg/24 h). However, recurrence of proteinuria with up to 3.3 g/24 h occurred 2 months after transplantation and the patient underwent intermediate immunoadsorption sessions with immediate reduction of proteinuria for the following year. She then received three doses of rituximab (600 mg, 375 mg/m(2)) that caused immediate reduction of proteinuria with only minimal increase in the following 12 months. Graft function is excellent 2 years after transplantation. These findings suggest that intermittent immunoadsorption combined with B-cell depletion by rituximab treatment induced prolonged reduction of proteinuria in a high-risk patient for recurrence of FSGS in the graft.
M3 - SCORING: Zeitschriftenaufsatz
VL - 20
SP - 1066
EP - 1071
JO - TRANSPL INT
JF - TRANSPL INT
SN - 0934-0874
IS - 12
M1 - 12
ER -
