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Randomized Controlled Trial
. 2007 Jan;7(1):117-21.
doi: 10.1111/j.1600-6143.2006.01613.x. Epub 2006 Nov 15.

Immunoadsorption in Severe C4d-positive Acute Kidney Allograft Rejection: A Randomized Controlled Trial

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Randomized Controlled Trial

Immunoadsorption in Severe C4d-positive Acute Kidney Allograft Rejection: A Randomized Controlled Trial

G A Böhmig et al. Am J Transplant. .
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Abstract

Antibody-mediated rejection (AMR) frequently causes refractory graft dysfunction. This randomized controlled trial was designed to evaluate whether immunoadsorption (IA) is effective in the treatment of severe C4d-positive AMR. Ten out of 756 kidney allograft recipients were included. Patients were randomly assigned to IA with protein A (N = 5) or no such treatment (N = 5) with the option of IA rescue after 3 weeks. Enrolled recipients were subjected to tacrolimus conversion and, if indicated, 'anti-cellular' treatment. All IA-treated patients responded to treatment. One death unrelated to IA occurred after successful reversal of rejection. Four control subjects remained dialysis-dependent. With the exception of one patient who developed graft necrosis, non-responders were subjected to rescue IA, however, without success. Because of a high graft loss rate in the control group the study was terminated after a first interim analysis. Even though limited by small patient numbers, this trial suggests efficiency of IA in reversing severe AMR.

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