Use of anti-CD20 antibody in the treatment of post-transplant glomerulonephritis Academic Article uri icon

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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.

authors

  • Damodar, Amar
  • Mustafa, Reem Adel
  • Bhatnagar, Jyotsna
  • Panesar, Mandip
  • Gundroo, Aijaz
  • Zachariah, Mareena
  • Blessios, George
  • Tornatore, Kathleen
  • Weber-Shrikant, Edit
  • Venuto, Rocco

publication date

  • May 2011

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