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논문분류	춘계학술대회 초록집
제목	Effectiveness of Combined therapy with Rituximab and Intravenous Immunoglobulin on Chronic Antibody Mediated Rejection in Kidney Transplant Recipients; Long-term Experience
저자	Tae Hyun Ban* 1, Ji Hyun Yu1, Byung Ha Chung1, Bum Soon Choi1, Cheol Whee Park1, Yong-Soo Kim1, Chul Woo Yang1
출판정보	2016; 2016(1):
키워드	chronic antibody mediated rejection, intravenous-immune globulin, Kidney transplantation, rituximab
초록	Background: Chronic active antibody-mediated rejection (CAMR) is a common cause of graft failure. However, standard treatment was not defined yet. We previously reported the effect of combination therapy with rituximab (RIT) and intravenous immunoglobulin (IVIg) on CAMR. In this study, we report the cumulative experience for combination therapy in CAMR since 2010. Methods: Forty-one patients diagnosed as CAMR were included. Patients were treated with RIT (375 mg/m2) and IVIg (0.4 g/kg) for 4 days. Mean time between kidney transplantation (KT) and combination therapy was 86.2 months and mean follow-up duration after combination therapy was 21.4 months. Response to combination therapy was evaluated as incline or stabilization of MDRD-eGFR for at least 12 months and three-year allograft survival rate after combination therapy. Risk factors associated with allograft failure were also analyzed. Results: Response rate for combination therapy was 41.2% (14/34), and 3-year survival rate was 61% (25/41). In response group, the allograft survival was greater than non-response group (85.7% vs. 30%, p<0.01). In multivariate cox regression analysis, the MDRD-eGFR and urine protein-to-creatinine ratio (uPCR) at the time of treatment were independent prognostic factors for allograft failure (p<0.01 and p<0.01, respectively). Conclusion: The combination therapy with RIT and IVIg is recommended as a strategy delaying allograft failure in CAMR.
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