Intravenous immunoglobulin therapy in kidney transplant recipients with de novo DSA: Results of an observational study.
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.We conducted a prospective observational study including 11 kidney...
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doaj-7da0c13cd4d944ceb518bccf55824a942020-11-24T22:04:00ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01126e017857210.1371/journal.pone.0178572Intravenous immunoglobulin therapy in kidney transplant recipients with de novo DSA: Results of an observational study.Marie MatignonCaroline PilonMorgane CommereucCynthia GrondinClaire LeiblerTomek KofmanVincent AudardJosé CohenFlorence Canoui-PoitrinePhilippe GrimbertApproximately 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.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-).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 FcγRIIA mRNA expression in circulating leukocytes, but did not affect the expression of any other markers of B cell activation.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.http://europepmc.org/articles/PMC5487035?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Marie Matignon Caroline Pilon Morgane Commereuc Cynthia Grondin Claire Leibler Tomek Kofman Vincent Audard José Cohen Florence Canoui-Poitrine Philippe Grimbert |
spellingShingle |
Marie Matignon Caroline Pilon Morgane Commereuc Cynthia Grondin Claire Leibler Tomek Kofman Vincent Audard José Cohen Florence Canoui-Poitrine Philippe Grimbert Intravenous immunoglobulin therapy in kidney transplant recipients with de novo DSA: Results of an observational study. PLoS ONE |
author_facet |
Marie Matignon Caroline Pilon Morgane Commereuc Cynthia Grondin Claire Leibler Tomek Kofman Vincent Audard José Cohen Florence Canoui-Poitrine Philippe Grimbert |
author_sort |
Marie Matignon |
title |
Intravenous immunoglobulin therapy in kidney transplant recipients with de novo DSA: Results of an observational study. |
title_short |
Intravenous immunoglobulin therapy in kidney transplant recipients with de novo DSA: Results of an observational study. |
title_full |
Intravenous immunoglobulin therapy in kidney transplant recipients with de novo DSA: Results of an observational study. |
title_fullStr |
Intravenous immunoglobulin therapy in kidney transplant recipients with de novo DSA: Results of an observational study. |
title_full_unstemmed |
Intravenous immunoglobulin therapy in kidney transplant recipients with de novo DSA: Results of an observational study. |
title_sort |
intravenous immunoglobulin therapy in kidney transplant recipients with de novo dsa: results of an observational study. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2017-01-01 |
description |
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.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-).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 FcγRIIA mRNA expression in circulating leukocytes, but did not affect the expression of any other markers of B cell activation.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. |
url |
http://europepmc.org/articles/PMC5487035?pdf=render |
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