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Immunoglobulin Therapy for Plasma Cell-Rich Rejection in the Renal Allograft.
Transplantation. 2006 Aug 27;82(4):567-569.
Adrogue HE, Soltero L, Land GA, Ramanathan V, Truong LD, Suki WN.
1Nephrology
Section, Baylor College of Medicine, The Methodist Hospital, Houston,
TX. 2HLA and Transplant Immunology, The Methodist Hospital, Houston,
TX. 3Department of Pathology, The Methodist Hospital and Baylor College
of Medicine, Houston, TX. 4The Kidney Institute, Houston, TX.
Plasma
cell-rich acute rejection (PCAR) is associated with poor allograft
outcome in renal transplantation.
Previous studies report a graft
half-life of six months after a single PCAR episode. However, the
management of this condition is unclear. Intravenous immunoglobulin
(IVIG) therapy, by virtue of its immunomodulating properties, and its
influence on B-cell maturation into plasma cells, may be a good
candidate for reversing this type of rejection. We report four episodes
of PCAR in two patients who responded well to IVIG with improvement in
renal function.
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