医学
托珠单抗
美罗华
肾移植
移植
内科学
背景(考古学)
抗体
阿巴塔克普
免疫学
胃肠病学
泌尿科
外科
疾病
生物
古生物学
作者
M. Joan Massat,Nicolas Congy‐Jolivet,Anne‐Laure Hebral,Laure Esposito,Olivier Marion,Audrey Delas,Magali Colombat,Stanislas Faguer,Nassim Kamar,Arnaud Del Bello
摘要
Antibody-mediated rejection (AMR) that resists to standard of care (SOC) therapy remains a major challenge after kidney transplantation and leads to graft failure in a majority of cases. The use of anti-IL6 receptor antibodies was suggested to treat chronic antibody-mediated rejection (cAMR) after failure of classical treatments. We treated nine patients with AMR resistant to apheresis, rituximab, and intravenous immunoglobulins, with a monthly infusion of tocilizumab and compared them with a historical cohort of 37 patients with similar clinical, immunological, and histological characteristics. The 1-year graft survival and the decline in renal function did not differ between patients who received tocilizumab and those who did not. Histological follow-up showed that despite a decrease in inflammation and tubulitis scores after tocilizumab, the course of antibody-mediated lesions and chronic glomerulopathy were similar in both groups. In our study, the addition of monthly infusions of tocilizumab did not alter the course of AMR that resist to SOC therapy. Large randomized studies are urgently needed to assess the effect of tocilizumab in this context.
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