1.Refractory antibody-mediated rejection after high-emergency lung transplantation for dermatomyositis with anti-MDA5 antibody:a case report
Louise CHANTELOT ; Domitille MOUREN ; Jean-Luc TAUPIN ; Aurélie CAZES ; Jonathan MESSIKA ; Cendrine GODET ; Mathilde SALPIN ; Gaelle WEISENBURGER ; Brice LORTAT-JACOB ; Pierre MORDANT ; Jean-François ALEXANDRA ; Raphael BORIE ; Chloé COMARMOND ; Yves ALLENBACH ; Yurdagül UZUNHAN ; Hervé MAL ; Antoine ROUX ; Vincent BUNEL
Clinical Transplantation and Research 2025;39(4):378-383
This case report describes a female with amyopathic anti-MDA5+ dermatomyositis who underwent emergency double lung transplantation due to rapidly progressive interstitial lung disease. Following transplantation, she developed acute antibody-mediated rejection (AMR). Despite multiple rounds of immunosuppressive therapy, her condition continued to deteriorate, and her donor-specific anti-human leukocyte antigen antibody levels increased markedly. An experimental treatment, imlifidase—an immunoglobulin G endopeptidase—was employed as a rescue therapy. This case highlights the complexity of posttransplant management of AMR and emphasizes the need for dedicated clinical trials to provide additional data.
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