Fatal Invasive Pulmonary Aspergillosis after Combined Induction with Rituximab and Antithymocyte Globulin for Kidney Transplantation in a Sensitized Recipient, and Early Rejection Therapy with Plasmapheresis and Low-dose Immunoglobulin.
10.4285/jkstn.2017.31.1.52
- Author:
Da Wun JEONG
1
;
Sang Ho LEE
;
Ju Young MOON
;
Yang Gyun KIM
;
Yu Ho LEE
;
Kipyo KIM
;
Hochul PARK
;
Sun Hyung JOO
Author Information
1. Division of Nephrology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea. lshkidney@khu.ac.kr
- Publication Type:Case Report
- Keywords:
Invasive pulmonary aspergillosis;
Combined desensitization induction;
Kidney transplantation
- MeSH:
Antilymphocyte Serum*;
Humans;
Immunoglobulins*;
Invasive Pulmonary Aspergillosis*;
Kidney Transplantation*;
Kidney*;
Leukocytes;
Lung;
Opportunistic Infections;
Plasmapheresis*;
Rituximab*;
Transplants
- From:The Journal of the Korean Society for Transplantation
2017;31(1):52-57
- CountryRepublic of Korea
- Language:English
-
Abstract:
A high degree of sensitization to human leukocyte antigen requires more intensive induction therapy; however, this increases vulnerability to opportunistic infections following kidney transplantation. Although recent studies have suggested that combined induction therapy with antithymocyte globulin and rituximab would be more effective in highly sensitized kidney recipients, we experienced a case of near-fatal invasive pulmonary aspergillosis 2 months after combined induction and early rejection therapy for graft dysfunction. Fortunately, the patient recovered with intensive antifungal treatment and lung lobectomy for a necrotic cavity. Antifungal prophylaxis should be considered in cases undergoing intensive induction therapy.
