TY - JOUR
T1 - Low-dose rituximab therapy for antibody-mediated rejection
T2 - In a highly sensitized heart-transplant recipient
AU - Aggarwal, Ashim
AU - Pyle, Joseph
AU - Hamilton, John
AU - Bhat, Geetha
PY - 2012/12/1
Y1 - 2012/12/1
N2 - Antibody-mediated rejection is the B-cell-mediated production of immunoglobulin G antibody against the transplanted heart. The currently available therapies for antibody-mediated rejection have had marginal success, and chronic manifestations of rejection can result in an increased risk of graft vasculopathy and perhaps require repeat transplantation. Rituximab, a monoclonal antibody directed against the CD20 receptor of B-lymphocytes and approved as therapy for lymphoma, can be used in heart-transplant patients for the management of antibody-mediated rejection. We present the case of a 52-year-old woman with high allosensitization (pre-transplantation panel reactive antibody level, 72%) who underwent successful orthotopic heart transplantation. Postoperatively, her acute antibody-mediated rejection with concomitant cellular rejection was successfully treated with low-dose rituximab. The patient died 5 months later because of multiple other medical problems. The resent case suggests a role for low-dose rituximab as therapy for antibody-mediated rejection in heart-transplant patients.
AB - Antibody-mediated rejection is the B-cell-mediated production of immunoglobulin G antibody against the transplanted heart. The currently available therapies for antibody-mediated rejection have had marginal success, and chronic manifestations of rejection can result in an increased risk of graft vasculopathy and perhaps require repeat transplantation. Rituximab, a monoclonal antibody directed against the CD20 receptor of B-lymphocytes and approved as therapy for lymphoma, can be used in heart-transplant patients for the management of antibody-mediated rejection. We present the case of a 52-year-old woman with high allosensitization (pre-transplantation panel reactive antibody level, 72%) who underwent successful orthotopic heart transplantation. Postoperatively, her acute antibody-mediated rejection with concomitant cellular rejection was successfully treated with low-dose rituximab. The patient died 5 months later because of multiple other medical problems. The resent case suggests a role for low-dose rituximab as therapy for antibody-mediated rejection in heart-transplant patients.
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M3 - Article
C2 - 23304051
AN - SCOPUS:84874059891
SN - 0730-2347
VL - 39
SP - 901
EP - 905
JO - Texas Heart Institute Journal
JF - Texas Heart Institute Journal
IS - 6
ER -