Rituximab in the treatment of acute cellular rejection of renal allograft with CD20-positive clusters in the infiltrate

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dc.contributor.authorVega, Jorge
dc.contributor.authorGoecke, Helmuth
dc.contributor.authorCarrasco, Alejandra
dc.contributor.authorEscobar, Carlos
dc.contributor.authorEscobar, Max
dc.contributor.authorEspinosa, Roberto
dc.contributor.authorMendez, Gonzalo
dc.contributor.authorde los Angeles Rodriguez, Maria
dc.date.accessioned2025-01-21T00:02:19Z
dc.date.available2025-01-21T00:02:19Z
dc.date.issued2011
dc.description.abstractA 31-year-old woman with nephronophthisis received a cadaveric kidney transplant, and was immunosuppressed with cyclosporine, azathioprine and steroids. Twelve days after transplant a biopsy showed acute rejection with vascular damage. She was treated with 3 pulses of methylprednisolone and change of immunosuppression to mycophenolate mofetil and tacrolimus, without improving graft function. At day 21, a second biopsy showed accentuation of interstitial and vascular rejection. Antibody-mediated rejection was suspected and plasmapheresis and rituximab were prescribed. Graft function improved rapidly. Staining for C4d was negative and there were no circulating antibodies against the donor. In the interstitial infiltrate there were clusters of B lymphocytes that accounted for 40% of cells, which was thought to be an ominous sign, as it has been associated with poor graft outcome. Acute T-cell-mediated rejection grade III (Banff 07) was diagnosed. Thirty-nine months after transplant her kidney function is stable with no other complication. This clinical case generates the hypothesis that rituximab may have a beneficial role in the therapy of acute cellular rejection when there are clusters of B lymphocytes in the infiltrate and a good response has not been obtained to conventional anti-rejection therapy.
dc.fuente.origenWOS
dc.identifier.doi10.1007/s10157-010-0387-8
dc.identifier.eissn1437-7799
dc.identifier.issn1342-1751
dc.identifier.urihttps://doi.org/10.1007/s10157-010-0387-8
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/95419
dc.identifier.wosidWOS:000289435700020
dc.issue.numero2
dc.language.isoen
dc.pagina.final311
dc.pagina.inicio308
dc.revistaClinical and experimental nephrology
dc.rightsacceso restringido
dc.subjectKidney transplantation
dc.subjectRituximab
dc.subjectMycophenolate
dc.subjectAcute rejection
dc.subjectB lymphocytes
dc.subjectTreatment
dc.subjectPrognosis
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleRituximab in the treatment of acute cellular rejection of renal allograft with CD20-positive clusters in the infiltrate
dc.typeartículo
dc.volumen15
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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