Abstract:

BACKGROUND: The acute humoral rejection after renal transplantation is a kind of human leukocyte antigen antibody-mediated rejection, which often leads to the loss of graft’s function. At present the application of potent immunosuppressive agents and B lymphocyte inhibitors significantly improve reversal rate of acute humoral rejection.
OBJECTIVE: To explore the therapeutic regimen of acute humoral rejection after renal transplantation.
METHODS: A total of 20 cases with acute humoral rejection in renal transplant recipients were retrospectively analyzed, patients were treated with antithymocyte globulin, protein A immunoadsorption and large dose gamma globulin therapeutic alliance. All patients were first received protein A immunoadsorption treatment before and after the last treatment, blood preparation was used to detect panel reaction antibody and serum immune globulin IgG, IgA, IgM.
RESULTS AND CONCLUSION: Twenty cases with acute humoral rejection were effectively reverse. After 48 months follow-up, 1case stopped using immunodepressant due to severe pulmonary infection at 5 months after renal transplantation. And then gravis acute rejection was occurred, patients underwent removal of transplanted renal, hemodialysis was recovered. The graft function of the remaining patients is good, the average serum creatinine concentration was (132.6±44.2) µmol/L to the end point of follow-up. It is indicated that antithymocyte globulin combined with protein A immunoadsorption and large dose gamma globulin can effectively reverse acute humoral rejection after renal transplantation with high success rate, few complication, and completely reversed acute humoral rejection does not affect the prognosis of graft.