High-Dose Intravenous Immunoglobulin and Rituximab Treatment for Antibody-Mediated Rejection After Kidney Transplantation: A Cost Analysis

B. Tanriover, S. E. Wright, S. V. Foster, K. S. Roush, J. A. Castillo-Lugo, K. Fa, F. L. Levy, A. Mejia

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18 Scopus citations

Abstract

Antibody-mediated rejection (AMR) generally occurs in highly sensitized patients. A pilot study was performed on 7 consecutive patients with AMR to assess the efficacy of high-dose intravenous immunoglobulin (IVIG; 2 g/kg) + rituximab (RTX; 375 mg/m2) without plasmapheresis. After a 24-month follow-up, 1- and 2-year allograft survivals were 86% and 58%, respectively. C4d became negative in 1 patient posttreatment. Donor-specific antibody (DSA) titers decreased to less than 1:4 in 2 cases. There were 4 infectious complications and 1 case of aseptic meningitis followed by cranial nerve VI palsy. The average hospital charge for 1 administration of IVIG + RTX, including hospital stay and renal biopsy expenses, was approximately $49,000. A combination of IVIG + RTX in late AMR may be beneficial but is an expensive treatment approach for selected renal transplant patients.

Original languageEnglish (US)
Pages (from-to)3393-3396
Number of pages4
JournalTransplantation Proceedings
Volume40
Issue number10
DOIs
Publication statusPublished - Dec 2008

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ASJC Scopus subject areas

  • Surgery
  • Transplantation

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