Treatment of acute antibody-mediated rejection using XXXX : a case report.

@entity1 @entity32 @entity1199 @entity1011 @entity1749 @entity479
Here we report the successful treatment of acute antibody-mediated rejection (AMR) with @entity1749 . @entity1749 rescue treatment was administered after a 42-year-old @entity1 failed to respond to @entity479 pulse and plasmapheresis with intravenous immunoglobulin (IVIG). The @entity1 underwent a second renal transplantation with a deceased donor kidney. She was treated pre-operatively with rituximab (200   mg/body) and underwent plasmapheresis twice (day-1 and operation day) because ELISA screening revealed that her pre-operative peak panel reactive antibody (PRA) composition was 100% class I and 100% class II and 15 times of cross-match positive history during the waiting period for transplantation. The @entity1 received induction therapy with Simulect (an @entity1199 -blocking agent). A 1-hour protocol biopsy revealed C4d-positivity and mild @entity32 . This was suggestive of early AMR-associated changes. After transplantation, the @entity1 underwent plasmaphereses (nine times) with low-dose IVIG (2   mg/kg). Despite this treatment regimen, serum @entity1011 levels increased to 3.4   mg/dL on post-transplant day 15. A second graft biopsy was performed, which showed overt AMR with glomerulitis, @entity32 and no C4d deposition. On post-operative day (POD) 22, treatment with four doses of @entity1749 (1.3   mg/m(2) ) was initiated with the @entity1 's consent. On POD 55, renal function had recovered and serum @entity1011 was 1.5   mg/dL. In summary, @entity1749 was administered as a rescue treatment for a @entity1 who developed AMR that was refractory to a combination of plasmaphereses with low-dose IVIG and preemptive administration of rituximab.
