대한신장학회

Skip Navigation: Skip to contents

KOR
ENG
전체메뉴보기

간행물 검색

현재 페이지 경로

HOME
간행물
간행물 검색

논문분류	춘계학술대회 초록집
제목	Early Outcomes of Tocilizumab (Anti-IL-6R Monoclonal) Treatment for Chronic Active Antibody-Mediated Rejection in Kidney Transplant Recipients
저자	Haeun Lee
출판정보	2023; 2023(1):
키워드
초록	Objectives: Chronic active antibody-mediated rejection (cABMR) is a leading cause of kidney allograft failure. Anti-humoral therapies such as plasma exchange, intravenous immunoglobulins (IVIG), and rituximab failed to show effectiveness on cABMR. Tocilizumab (TCZ), a humanized anti-Interleukin-6 (IL-6) receptor monoclonal antibody, may be a potential treatment option for cABMR by regulating inflammation and alloantibody production. Methods: Thirteen kidney transplant (KT) recipients received TCZ treatment for cABMR in Seoul St. Mary’s Hospital between 2019 and 2022. TCZ was administered at a monthly dose of 8mg/kg (maximum 800mg) for up to 6 months. If a patient’s Immunoglobulin G level is ≤ 600mg/L, they were given a dose of 0.5mg/kg IVIG before receiving TCZ. Mean follow-up period was 10.0 months. Results: Five out of thirteen patients had donor specific anti-HLA antibodies (HLA-DSA) at the time of biopsy. The mean fluorescence intensity (MFI) values of HLA-DSA were decreased after TCZ treatment in 3 patients. One patient experienced graft failure after 1 session of TCZ and showed an increase in HLA-DSA MFI. One patient undergoing treatment needs monitoring of HLA-DSA MFI (Fig. 1A). Five patients experienced death-censored graft failure. Patients with graft failure more frequently had a history of antibody-mediated rejection, a lower estimated glomerular filtration rate (eGFR), and a higher levels of proteinuria, although this difference was not statistically significant. One patient was diagnosed with pneumonia. No patient deaths were reported. (Table 1). In patients without graft failure, eGFR stabilized after starting TCZ with ΔeGFR of 13.0 mL/min/1.73m2 (6 months pre-treatment) to 0.4 mL/min/1.73m2 (6 months post-treatment) (Fig. 1B) and the amount of proteinuria reduced (Fig. 1C). Conclusions: Even though patients with far advanced cABMR suffered allograft failure during treatment, patients without graft failure showed a decrease in HLA-DSA MFI and stabilization of allograft function. Our study suggests that early application of TCZ can give benefit for cABMR patients.
원문(PDF)	PDF 원문보기

목록

위로가기