Anti-CD20 monoclonal antibody (rituximab) therapy for acute cardiac humoral rejection: a case report

Transplantation. 2002 Mar 27;73(6):907-10. doi: 10.1097/00007890-200203270-00013.


Humoral or antibody-mediated rejection in cardiac transplant recipients is mediated by donor-specific cytotoxic antibodies and is histologically defined by linear deposits of immunoglobulin and complement in the myocardial capillaries. Antibody-mediated rejection often is accompanied by hemodynamic compromise and is associated with reduced long-term graft survival. Standard immunosuppression, designed to target T cell immune function, is largely ineffective against this B cell-driven process. Current treatment options for humoral rejection are limited by a lack of specific anti-B cell therapies. We present the case of a 50-year-old woman with hemodynamically significant humoral rejection resistant to steroids, cyclophos-phamide, and plasmapheresis who responded to the addition of anti-CD20 monoclonal antibody therapy (rituximab). One year posttransplant, the patient is rejection-free, with normal left ventricular systolic function and coronary arteries.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Murine-Derived
  • Antibody Formation
  • Antigens, CD20 / immunology
  • B-Lymphocytes / immunology*
  • Cardiomyopathies / surgery
  • Drug Resistance
  • Female
  • Graft Rejection / drug therapy*
  • HLA Antigens / immunology
  • Heart Transplantation / immunology*
  • Heart Transplantation / pathology
  • Hemodynamics
  • Humans
  • Middle Aged
  • Rituximab
  • Time Factors
  • Treatment Outcome


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD20
  • HLA Antigens
  • Rituximab