Treatment of vascular rejection with rituximab in cardiac transplantation. Export

@article{citeulike:591377, abstract = {BACKGROUND: Vascular rejection is the B-cell-mediated production of immunoglobulin G (IgG) antibody against the transplanted heart. The currently available treatments for vascular rejection have had limited success, and chronic manifestations of vascular rejection require re-transplantation. Rituximab is a monoclonal antibody directed against the CD20 receptor of B-lymphocytes, which is approved for treatment of lymphoma. METHODS: Vascular rejection was defined as positive immunofluorescent endomyocardial biopsy staining for IgG and complement, 25\% reduction in left ventricular ejection fraction (LVEF) from baseline, and absence of cellular rejection. Over the last 3 years, 8 patients with vascular rejection were treated with intravenous rituximab at a dose of 375 mg/m2 per week for 4 weeks. RESULTS: All patients had normal LVEF post-transplant (average 58\%), but developed left ventricular dysfunction (average decrease of 43\%) associated with endomyocardial biopsy evidence of vascular rejection. Post-treatment, LVEF returned to baseline (average 53\%) with complete resolution of immunofluorescent staining by endomyocardial biopsy. No patient suffered significant infection or drug-related complications. CONCLUSIONS: Rituximab is beneficial for treatment of vascular rejection. Further study is indicated to verify the safety, efficacy and mechanism of action of rituximab therapy for vascular rejection.}, address = {Division of Cardiothoracic Surgery, Baptist/UT Heart Transplant Program, University of Tennessee, Memphis, Tennessee 38120, USA. beth@cvsclinic.com}, author = {Garrett, H. E. and Duvall-Seaman, D. and Helsley, B. and Groshart, K.}, citeulike-article-id = {591377}, citeulike-linkout-0 = {http://dx.doi.org/10.1016/j.healun.2004.09.003}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/16143254}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=16143254}, doi = {10.1016/j.healun.2004.09.003}, issn = {1557-3117}, journal = {J Heart Lung Transplant}, keywords = {c4d, rejection, transplant}, month = {September}, number = {9}, pages = {1337--1342}, posted-at = {2006-04-19 18:20:32}, priority = {2}, title = {Treatment of vascular rejection with rituximab in cardiac transplantation.}, url = {http://dx.doi.org/10.1016/j.healun.2004.09.003}, volume = {24}, year = {2005} }

TY - JOUR ID - citeulike:591377 L3 - citeulike-article-id:591377 N2 - BACKGROUND: Vascular rejection is the B-cell-mediated production of immunoglobulin G (IgG) antibody against the transplanted heart. The currently available treatments for vascular rejection have had limited success, and chronic manifestations of vascular rejection require re-transplantation. Rituximab is a monoclonal antibody directed against the CD20 receptor of B-lymphocytes, which is approved for treatment of lymphoma. METHODS: Vascular rejection was defined as positive immunofluorescent endomyocardial biopsy staining for IgG and complement, 25% reduction in left ventricular ejection fraction (LVEF) from baseline, and absence of cellular rejection. Over the last 3 years, 8 patients with vascular rejection were treated with intravenous rituximab at a dose of 375 mg/m2 per week for 4 weeks. RESULTS: All patients had normal LVEF post-transplant (average 58%), but developed left ventricular dysfunction (average decrease of 43%) associated with endomyocardial biopsy evidence of vascular rejection. Post-treatment, LVEF returned to baseline (average 53%) with complete resolution of immunofluorescent staining by endomyocardial biopsy. No patient suffered significant infection or drug-related complications. CONCLUSIONS: Rituximab is beneficial for treatment of vascular rejection. Further study is indicated to verify the safety, efficacy and mechanism of action of rituximab therapy for vascular rejection. IS - 9 JF - J Heart Lung Transplant SN - 1557-3117 AD - Division of Cardiothoracic Surgery, Baptist/UT Heart Transplant Program, University of Tennessee, Memphis, Tennessee 38120, USA. beth@cvsclinic.com EP - 1342 TI - Treatment of vascular rejection with rituximab in cardiac transplantation. VL - 24 SP - 1337 KW - c4d KW - rejection KW - transplant AU - Garrett, HE AU - Duvall-Seaman, D AU - Helsley, B AU - Groshart, K PY - 2005/09// UR - http://dx.doi.org/10.1016/j.healun.2004.09.003 ER -