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Daratumumab followed by tocilizumab for treatment of late antibody-mediated rejection in renal transplant recipients with high or moderate levels of de novo donor-specific antibodies: a pilot study.
BMC Nephrol
January 2025
Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Key Laboratory of Organ Transplantation, NHC Key Laboratory of Organ Transplantation, Key Laboratory of Organ Transplantation, Huazhong University of Science and Technology, Ministry of Education, Chinese Academy of Medical Sciences, Wuhan, China.
Background: Effective treatment of late antibody-mediated rejection (late AMR) is still an unmet medical need. Clearing donor-specific antibody (DSA) and preventing its rebound is the ideal goal of treatment.
Methods: We have summarized the clinical data from seven patients with late or chronic active AMR after renal transplantation who received daratumumab (Dara)-based treatment first (Phase 1) and then tocilizumab (TCZ) therapy (Phase 2).
C4d immunostaining facilitates differentiation of pemphigoid nodularis from prurigo nodularis.
Pathol Res Pract
December 2024
Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, China. Electronic address:
Pemphigoid nodularis and prurigo nodularis have similar clinicopathological features and are difficult to distinguish. Enzyme-linked immunosorbent assays (ELISA) and direct/indirect immunofluorescence can support the diagnosis of pemphigoid nodularis, but sometimes show contradictory results or are unavailable. We aimed to develop a practical method for differentiating between pemphigoid nodularis and prurigo nodularis.
View Article and Find Full Text PDF[Early-onset antibody-mediated rejection with fever as the main manifestation after bilateral lung transplantation: a case report].
Zhonghua Jie He He Hu Xi Za Zhi
December 2024
Department of Lung Transplantation, China-Japan Friendship Hospital; National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences,Beijing100029, China.
Antibody-mediated rejection (AMR) is a recognized cause of allograft dysfunction in lung transplant recipients due to the presence of donor-specific anti-human leukocyte antigen (HLA) antibodies (DSAs). Here, we reported that a 69-year-old woman with underlying connective tissue disease-associated interstitial lung disease (CTD-ILD) developed recurrent fever with elevated white blood cells, C-reactive protein (CRP) and new ground-glass opacities on chest computed tomography (CT) early after double lung transplantation. After a thorough investigation for infection, rejection and relapse of primary immune diseases, the patient was found to be panel-reactive antibody (PRA) positive and DSAs positive.
View Article and Find Full Text PDFRe-Evaluating the Transplant Glomerulopathy Lesion-Beyond Donor-Specific Antibodies.
Transpl Int
December 2024
Nephrology, Medicine, Research in Kidney Transplantation, Faculty in Human Translational Immunology and Translational Biomedicine, Yale School of Medicine, New Haven, CT, United States.
There have been significant advances in short-term outcomes in renal transplantation. However, longer-term graft survival has improved only minimally. After the first post-transplant year, it has been estimated that chronic allograft damage is responsible for 5% of graft loss per year.
View Article and Find Full Text PDFEarly and late antibody mediated rejection: Which game is the complement playing?
Transplant Rev (Orlando)
January 2025
Nephrology Unit, Parma University Hospital, & Department of Medicine and Surgery, University of Parma, Parma, Italy.
Article Synopsis
- * Despite the known association with complement activation, evidence shows that microvascular inflammation and endothelial damage can occur independently of this system, particularly in late AMR (>6 months post-transplant).
- * The review discusses differences in mechanisms and clinical features between early and late AMR, suggesting that treatment strategies should reflect these variations in underlying inflammatory processes and complement activation levels.
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