小児腎移植患者に発症した抗体関連型拒絶反応治療におけるIVIgを投与した症例の全国調査

抄録

We retrospectively surveyed the status of IVIg use in the treatment for antibody-mediated rejection (AMR) in pediatric kidney transplant recipients in Japan between 2001 and 2022. We collected clinical information in 17 recipients from 9 institutes. The median dose of IVIg was 0.74 g/kg, and the range was widely distributed from 0.10 g/kg to 2.06 g/kg. The graft survival at 6 months and 12 months after the administration of IVIg was 100 and 93.3%. Fifteen patients were treated with IVIg and other treatment options, and in most cases, IVIg was considered as the first-line or second-line treatment for AMR. Among 16 donor-specific anti-HLA antibodies (DSAs) which were followed before and after the treatment, the MFI of 12 DSAs was markedly decreased after the administration of IVIg. No adverse events related to thrombotic complications were reported from this survey. From this survey, it was suggested that IVIg treatment for AMR in Japanese pediatric kidney transplant recipients was effective in terms of allograft survival and decreased MFI of DSAs.