Long-term experience of plasmapheresis in antibody-mediated rejection in renal transplantation
Department of Nephrology, Beaumont Hospital, Dublin, Ireland.Transplantation proceedings 01/2009; 41(9):3690-3692. DOI:10.1016/j.transproceed.2009.06.197 ISBN: 1873-2623; 0041-1345
ABSTRACT JID: 0243532; 0 (Antibodies, Monoclonal); 0 (Immunoglobulins, Intravenous); 0 (Immunosuppressive Agents); 0 (Isoantibodies); 0 (rituximab); 60-27-5 (Creatinine); 2009/04/13 [received]; 2009/06/03 [accepted]; ppublish
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ABSTRACT: Therapeutic plasma exchange is an extracorporeal treatment modality that removes systemic circulating pathologic factors or replaces absent plasma components and plays a role in many nephrologic conditions. It presents a number of technical challenges in the pediatric population but has become an increasingly common practice in pediatric nephrology over the past several decades. While prospective evidence is often lacking, our increased understanding of the molecular pathogenesis underlying many pediatric renal diseases provides sound reasoning for the use of plasma exchange in treating these conditions. This review will present the currently accepted indications for plasma exchange in children, the technical aspects of the procedure and its potential complications.Pediatric Nephrology 06/2013; · 2.94 Impact Factor
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ABSTRACT: Various lineages of B cells are being increasingly recognized as important players in the etiology and prognosis of both acute and chronic graft rejection. The role of immature, chronically activated B cells, as efficient antigen-presenting cells, supporting recalcitrant cell-mediated graft rejection and late lineage B cells driving humoral rejections, is being increasingly recognized. This review captures the recent literature on this subject and discusses the various roles of the B cell in renal graft rejection and conversely, also in graft tolerance, both in animal and human studies. In addition, novel therapies targeting specific B-cell lineages in graft rejection are also discussed, with a view to developing more targeted therapies for graft rejection.Transplantation reviews (Orlando, Fla.) 02/2010; 24(2):67-78.
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ABSTRACT: In use for over 50 years, the rationale for plasmapheresis remains based largely on case series and retrospective studies. Recently, results from several randomized controlled trials, meta-analyses, and prospective studies have shown plasmapheresis may be of benefit in various renal diseases, and have provided insights into more rational use of this therapy. A multicenter trial by the European Vasculitis Study Group has shown it is the preferred additional form of therapy for patients with anti-neutrophil cytoplasmic antibody-associated glomerulonephritis and severe renal failure. A recent study conducted at Mayo Clinic also found it effective at reversing renal failure from myeloma-related cast nephropathy if serum free light chain levels were reduced by at least 50%. In addition, a Cochrane review has analyzed the available evidence for its use in thrombotic thrombocytopenic purpura and hemolytic uremic syndrome. The objective of this article is to review recent and past evidence and, thereby, the current indications for treatment in renal disease.Journal of Artificial Organs 12/2010; 14(1):9-22. · 1.41 Impact Factor
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