Journal ArticleDOI
Use of anti-CD20 antibody in the treatment of post-transplant glomerulonephritis
Amar Damodar,Reem A. Mustafa,Jyotsna Bhatnagar,Mandip Panesar,Aijaz Gundroo,Mareena Zachariah,George A. Blessios,Kathleen M. Tornatore,Edit Weber-Shrikant,Rocco C. Venuto +9 more
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TLDR
The use of anti‐CD20 antibody in the treatment of post‐transplant glomerulonephritis is described as a ‘breakthrough therapy’ and the use of this antibody in clinical practice is recommended.Abstract:
Post-transplant glomerulonephritis (PTGN) accounts for 4-10% of late graft loss. Six consecutive patients who developed PTGN 3-72 months post-transplant presented to our center with deteriorating kidney function and proteinuria. Three had focal segmental glomerulosclerosis; one had membranoproliferative glomerulonephritis Type 1; one recurrent membranous nephropathy; and one recurrent immunoglobin A nephropathy. All six were treated with an aggressive immunosuppression regimen including rituximab, pulse steroids and/or maximization of mycophenolic acid and calcineurin inhibitor therapy. Four of the six patients received plasma exchange. The patients were followed for a minimum of nine months after treatment. Proteinuria decreased from 7.2 ± 4.4 to 1.4 ± 1.5g (p = 0.04), while mean estimated glomerular filtration rate was 31.2 ± 13.1 and 42.5 ± 21.7 mL/min (p = 0.07) at nine months. No adverse events were noted. These observations suggest that immune modulating therapy may be of benefit in the treatment of PTGN.read more
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Journal ArticleDOI
Rituximab Treatment Prevents the Early Development of Proteinuria following Pig-to-Baboon Xeno-Kidney Transplantation
TL;DR: It is demonstrated that rituximab prevents the disruption of pig podocytes in an SMPDL-3b-dependent manner in vitro and the early development of proteinuria after xenogeneic kidney transplantation in baboons.
Journal ArticleDOI
Membranous Nephropathy Posttransplantation: An Update of the Pathophysiology and Management.
Juliette Leon,María José Pérez-Sáez,Ibrahim Batal,Laurence H. Beck,Helmut G. Rennke,Guillaume Canaud,Christophe Legendre,Julio Pascual,Leonardo V. Riella +8 more
TL;DR: This review aims to synthesize and update the pathophysiology of post-transplant MN, as well as to address unsolved issues specific to transplantation, including the prognostic value of antiPLA2R, the risk of living-related donation, the link between de novo MN and rejection, and different therapeutic strategies so far deployed.
Journal ArticleDOI
Treatment-resistant recurrent membranoproliferative glomerulonephritis in renal allograft responding to rituximab: case report.
TL;DR: A case of idiopathic membranoproliferative glomerulonephritis recurring 2 years after a living-unrelated kidney transplantation, which was refractory to intravenous immunoglobulin and plasmapheresis, is reported.
Journal ArticleDOI
Information received by secondary school teaching personnel about organ donation and transplantation: a study in the southeast of Spain.
Beatriz Febrero,Antonio Ríos,Laura Martínez-Alarcón,Ana I. López-Navas,J. Almela,José Elías García Sánchez,Guillermo Ramis,Pablo Ramírez,Pascual Parrilla +8 more
TL;DR: Teachers who reported having good information were more in favor of ODT than those who had limited or no information, and the social/family means has the most influence on attitude.
Journal ArticleDOI
Bordetella holmesii bacteremia in a renal transplant recipient: emergence of a new pathogen.
T. Chambaraud,Zara Dickson,G. Ensergueix,O. Barraud,Marie Essig,Celine Lacour,Julien Allard,Frederique Bocquentin,Jean-Claude Aldigier,J.P. Rerolle +9 more
TL;DR: The first case of B. holmesii bacteremia in a renal transplant recipient following rituximab therapy for recurrence of membranoproliferative glomerulonephritis is reported.
References
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Journal ArticleDOI
Rituximab, an Anti-CD20 Monoclonal Antibody: History and Mechanism of Action
TL;DR: A need for controlled clinical trials is clearly indicated before the widespread use of this drug in transplant, and the history, pharmacokinetics and potential mechanism of action of rituximab are reviewed.
Journal ArticleDOI
Risk of Renal Allograft Loss from Recurrent Glomerulonephritis
TL;DR: Recurrence is an important cause of allograft loss for those with renal failure due to glomerulonephritis and no risk factors for recurrence were identified that warrant altering the approach to transplantation.
Journal ArticleDOI
Rituximab treatment for glomerulonephritis in HCV-associated mixed cryoglobulinaemia: efficacy and safety in the absence of steroids
Luca Quartuccio,Giorgio Soardo,G Romano,Francesco Zaja,Cathryn Anne Scott,G. De Marchi,M. Fabris,Gianfranco Ferraccioli,S. De Vita +8 more
TL;DR: Rituximab may provide effective and safe therapy in type II MC-related glomerulonephritis, possibly as first-line therapy, avoiding steroids and hazardous immunosuppressive treatment.
Journal ArticleDOI
Resolution of recurrent focal segmental glomerulosclerosis proteinuria after rituximab treatment.
TL;DR: Focal segmental glomerulosclerosis recurs in about 30 percent of patients who undergo kidney transplantation for this condition and leads to the nephrotic syndrome and accelerated death in about half of patients.
Journal ArticleDOI
Mechanisms of immune-deposit formation and the mediation of immune renal injury.
TL;DR: The passive trapping of preformed immune complexes is responsible for some forms of glomerulonephritis that are associated with mesangial or subendothelial deposits, and particularly promising future therapeutic approaches include selective immunosuppression and interference in complement activation and C5b-9-mediated cell injury.