Bruna Cristina Cardoso Martins
Federal University of Ceara, Brazil
Graduated in Pharmacy from the Federal University of Ceará (2010), specialist in transplantation for the University Hospital Multidisciplinary Residency Walter Cantídio (2012), Title of specialist in Hospital Pharmacy from SBRAFH (2011) and Master in Pharmaceutical Sciences from the Federal University of Ceará (2014). PhD student in Pharmaceutical Sciences from the Federal University of Ceará.
Antibody-mediated rejection (AMR) is one of the important complications of renal transplant that results in the loss of the kidney graft when not treated. The Ministry of Health of the Brazil recommends the use of immunoglobulin (IVIg) or a combination of plasmapheresis (PP) for treatment. The aim of the study was to identify and describe the results of use of PF, IVIg and RIT in the treatment of AMR in after kidney transplantation in the literature. This is an integrative literature review using the key words: "rituximab", plasmaphereses", "immunoglobulin", "antibody-mediated rejection" and "kidney transplantation" in the databases PubMed, LILACS and Cochrane. Inclusion criteria were studies published between 2005 and 2015, follow-up type with clinical outcome analysis and combination of PP therapy and/or IVIG and/or RIT. The study included six papers, after analysis of 490 articles found. The mean duration of follow-up was 3.8 ± 1.9 years (min: 1, max: 6) and the number of monitored patients was on average 19.3 ± 18.0 (min:7, max:54). The studies analyzed that combined PP, IVIg and RIT, it was evaluated that there was articles in which the graft survival rate was 50% after 10 months of treatment, 71.4% at 1 year and 90% at the end of follow-up two years. In conclusion, the combination of PP, IVIg and RIT is protocol for the treatment of AMR in different transplant centers and were no differences between graft survival rates in relation to follow-up and early treatment, requiring the completion of prospective studies with longer follow-up.