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Comparison of Combination Plasmapheresis/IVIg/ Anti-CD20 Versus High-Dose IVIg in the Treatment of Antibody-Mediated Rejection

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Lefaucheur, C., Nochy, D., Andrade, J., Verine, J., Gautreau, C., Charron, D., Hill, G.S., Glotz, D., Suberbielle-Boissel, C.·2009·American Journal of Transplantation

Abstract

Different strategies appear to improve the success in treatment of antibody-mediated rejection (AMR), although no one best method has yet emerged. The objective of this study was to compare the efficacy of the combination of Plasmapheresis/intravenous immunoglobulin (IVIg)/anti-CD20-based regimes versus high-dose IVIg alone in the treatment of AMR. Group A (12 patients) was treated with high-dose IVIg between January 2000 and December 2003; group B (12 patients) was treated by Plasmapheresis/IVIg/anti-CD20 between January 2004 and December 2005. Graft survival at 36 months was 91.7% in group B versus 50% in group A (p = 0.02). Donor-specific human leukocyte antigens (DSA) levels detected by Luminex single antigen (Luminex SA) and ELISA, 3 months postrejection are significantly lower in group B than in group A: DSA ELISA class 2 score 6-8 (p = 0.02), DSA mean intensity of fluorescence (MFI) max (p = 0.009) and DSA mean MFI (p = 0.0004). The persistence of elevated DSA levels posttreatment is more frequent in patients with graft loss as compared to those with preserved renal function: score 6-8 on ELISA (p = 0.04); mean MFI (p = 0.00009) and MFImax (p = 0.018). We conclude that: (1) high dose IVIg alone is inferior to Plasmapheresis/IVIg/anti-CD20 as therapy for AMR and (2)DSA postrejection can be quantified using solid phase assays, showing that 3 months after AMR, DSA levels are higher in patients with graft loss.

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Metadata

Authors
Lefaucheur, C., Nochy, D., Andrade, J., Verine, J., Gautreau, C., Charron, D., Hill, G. S., Glotz, D., & Suberbielle-Boissel, C.
Venue
American Journal of Transplantation
Publisher
Elsevier BV
Published
2009-05
Volume
9
Issue
5
Pages
1099-1107
ISSN
1600-6135 (ISSN-L)
OpenAlex
W2061888899
Cited by
291
References
0
FWCI
12.92
Type
journal article
Language
en
Open access
hybrid

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CoChat. (2026). Citation check: Comparison of Combination Plasmapheresis/IVIg/ Anti-CD20 Versus High-Dose IVIg in the Treatment of Antibody-Mediated Rejection. https://app.cochat.ai/papers/10.1111/j.1600-6143.2009.02591.x
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Lefaucheur, C., Nochy, D., Andrade, J., Verine, J., Gautreau, C., Charron, D., Hill, G. S., Glotz, D., & Suberbielle-Boissel, C. (2009). Comparison of Combination Plasmapheresis/IVIg/ Anti-CD20 Versus High-Dose IVIg in the Treatment of Antibody-Mediated Rejection. American Journal of Transplantation. https://doi.org/10.1111/j.1600-6143.2009.02591.x

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