REDUCED HUMAN IgG ANTI-ATGAM ANTIBODY FORMATION IN RENAL TRANSPLANT RECIPIENTS RECEIVING MYCOPHENOLATE MOFETIL1,2

Kimball, Jess; Pescovitz, Mark D.; Book, Benita K.; Norman, Douglas J.

doi:10.1097/00007890-199560120-00001

Cited by 81 publications

(20 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…23 A previous study had already proved that MMF can inhibit in vitro antibody production by B cells. 24 This evidence suggests that it is Tac-MMF other than IA or PPH which is necessary in the treatment of AHR. Indeed, we are not the first to treat AHR without IA or PPH; Nickeleit et al 13 and Koo et al 14 reported that antilymphocytic preparation without IA or PPH can effectively rescue C4d-positive rejection with pronounced allograft dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Treatment of early mixed cellular and humoral renal allograft rejection with tacrolimus and mycophenolate mofetil

Sun

Liu

Zhang

et al. 2007

Kidney International

View full text Add to dashboard Cite

This prospective study investigated the efficiency of the tacrolimus (Tac) combined with mycophenolate mofetil (MMF) alone without immunoadsorption (IA) or plasmapheresis (PPH) as treatment for early (within 2 weeks) acute humoral rejection (AHR) in non-sensitized renal allograft recipients. Of 160 patients enrolled in this prospective study, 11 patients had histologically and clinically confirmed early steroid-resistant acute rejection with an antibody response and received Tac-MMF therapy. No other aggressive rescue methods such as IA, PPH were used, according to the study design. Patients (n=11) were followed for 13.8+/-3.5 months; nine were females. The complement-dependent cytotoxicity crossmatch was negative before transplantation in all patients and only positive for panel-reactive antibody in one patient. Most of the rejection episodes were mixed with cellular rejection (four patients met Banff IIA criteria, five patients met Banff IIB, one patient met Banff IB, and one patient met Banff borderline). After 16.19+/-6.16 days of treatment, all rejection episodes were successfully reversed and all graft functions were stable, with a mean serum creatinine level of 1.12+/-0.32 mg/dl during follow-up. No patient suffered from severe infectious complications (except one case of urinary infection). Our investigation suggests that Tac combined with MMF alone is adequate to reverse early mixed cellular and humoral C4d-positive rejection in non-sensitized renal allograft recipients.

show abstract

Section: Discussionmentioning

confidence: 99%

Treatment of early mixed cellular and humoral renal allograft rejection with tacrolimus and mycophenolate mofetil

Sun

Liu

Zhang

et al. 2007

Kidney International

View full text Add to dashboard Cite

show abstract

“…After MMF was introduced in renal transplantation, some reports have demonstrated its benefit in CAN (22)(23)(24). Ojo et al (22), in a study on 66,774 human renal allograft recipients, showed that MMF reduces late allograft loss independently of its effects on acute rejection.…”

Section: Subgroupsmentioning

confidence: 99%

“…Mycophenolate mofetil (MMF) has been used in solid organ transplants with good results on the reduction of acute rejection episodes and promoting good graft survival (22)(23)(24)(25)(26)(27). The effect of combined therapy with an angiotensin-converting enzyme inhibitor (ACEI) and MMF has only been analyzed in experimental studies, which showed a synergistic effect in reducing renal damage (28)(29)(30).…”

Section: Introductionmentioning

confidence: 99%

Synergistic effect of mycophenolate mofetil and angiotensin-converting enzyme inhibitor in patients with chronic allograft nephropathy

Moscoso-Solorzano

Kirsztajn

Ozaki

et al. 2009

Braz J Med Biol Res

View full text Add to dashboard Cite

Experimental data and few clinical non-randomized studies have shown that inhibition of the renin-angiotensin system by angiotensin-converting enzyme (ACE) associated or not with the use of mycophenolate mofetil (MMF) could delay or even halt the progression of chronic allograft nephropathy (CAN). In this retrospective historical study, we investigated whether ACE inhibition (ACEI) associated or not with the use of MMF has the same effect in humans as in experimental studies and what factors are associated with a clinical response. A total of 160 transplant patients with biopsy-proven CAN were enrolled. Eightyone of them were on ACE therapy (G1) and 80 on ACEI-free therapy (G2). Patients were further stratified for the use of MMF. G1 patients showed a marked decrease in proteinuria and stabilized serum creatinine with time. Five-year graft survival after CAN diagnosis was more frequent in G1 (86.9 vs 67.7%; P < 0.05). In patients on ACEI-free therapy, the use of MMF was associated with better graft survival. The use of ACEI therapy protected 79% of the patients against graft loss (OR = 0.079, 95%CI = 0.015-0.426; P = 0.003). ACEI and MMF or the use of MMF alone after CAN diagnosis conferred protection against graft loss. This finding is well correlated with experimental studies in which ACEI and MMF interrupt the progression of chronic allograft dysfunction and injury. The use of ACEI alone or in combination with MMF significantly reduced proteinuria and stabilized serum creatinine, consequently improving renal allograft survival.

show abstract

“…Cyclophosphamide may be more effective than azathioprine in suppressing B-lymphocyte activity accounting for it's incorporation into AMR treatment regimens (43). Augmentation of baseline immunosuppression with a switch in calcineurin inhibitors from cyclosporine to tacrolimus has also been used to treat AMR (44)(45)(46).…”

Section: Treatmentmentioning

confidence: 99%

Acute Antibody-Mediated Rejection Following Heart Transplantation

Uber¹,

Self²,

Bakel

et al. 2007

American Journal of Transplantation

View full text Add to dashboard Cite

Acute antibody-mediated rejection (AMR) in heart transplantation is often associated with hemodynamic compromise, and is associated with increased mortality and development of accelerated transplant coronary artery disease (TCAD). The diagnosis of AMR has historically been controversial and outcomes with aggressive immunosuppressive therapy including plasmapheresis and cyclophosphamide are poor. Advances in diagnostic techniques like the demonstration of immunopathologic evidence for antibodymediated rejection by deposition of the complement split product C4d in tissue and detection of anti-HLA antibodies by flow cytometry will assist in further characterizing AMR. Immunosuppression targeting B-lymphocytes and use of m-TOR inhibitors to alter the predilection to develop TCAD and improve survival in AMR remains to be proven.

show abstract

REDUCED HUMAN IgG ANTI-ATGAM ANTIBODY FORMATION IN RENAL TRANSPLANT RECIPIENTS RECEIVING MYCOPHENOLATE MOFETIL1,2

Cited by 81 publications

References 0 publications

Treatment of early mixed cellular and humoral renal allograft rejection with tacrolimus and mycophenolate mofetil

Treatment of early mixed cellular and humoral renal allograft rejection with tacrolimus and mycophenolate mofetil

Synergistic effect of mycophenolate mofetil and angiotensin-converting enzyme inhibitor in patients with chronic allograft nephropathy

Acute Antibody-Mediated Rejection Following Heart Transplantation

Contact Info

Product

Resources

About