There is insufficient information to comment on its use in CMV seronegative recipients of organs from seronegative donors. Extended duration of antiviral prophylaxis

in kidney and lung transplants has been shown to be more effective than standard 3 month prophylaxis. “
“Cases of life-threatening thromboses in pulmonary, coronary, cerebral and peripheral vessels are associated with high-dose intravenous immunoglobulin (IVIg) therapy that is generally considered safe. We experienced a patient Rapamycin mw with a renal graft rupture that developed after high-dose IVIg was administered for desensitization. A needle biopsy performed 4 days prior to the rupture revealed the presence of glomerular thrombosis and mesangiolysis. The ruptured nephrectomy specimen contained

renal infarction around the haemorrhagic segment and arterial wall thickening with intimal fibrosis. This might have contributed to rupturing associated with small arterial and glomerular arteriolar thrombi. This is the first case of a graft rupture as a complication of high-dose IVIg we have encountered. High-dose IVIg is commonly administered to treat immunodeficiencies Panobinostat purchase or various inflammatory disorders such as idiopathic thrombocytopenic purpura and autoimmune haemolytic anaemia. This therapeutic technique has been recently recognized as a modifier of complement activation, suggesting that IVIg could be clinically useful for desensitizing patients about to undergo solid organ transplantation and treating antibody-mediated rejection (AMR).[1, 2] Although high-dose IVIg is generally considered safe, cases of life-threatening thromboses in pulmonary, coronary, cerebral and peripheral vessels associated with this therapy have been reported.[3] The mechanisms underlying thrombosis development are IVIg-induced platelet activation, increased plasma viscosity and coagulation factor XI contamination.[4] A 46-year-old woman was hospitalized for a second renal transplantation from a 59-year-old deceased donor. Before transplantation, the

patient underwent desensitization with rituxan (200 mg/body). PAK5 She also received two rounds of high-dose IVIg (1 g/kg per day for 2 days) due to 100% PRA (panel reactive antibody) against class I and 92% against class IIHLA antigens as well as positive cross-match test results against T cells. The allograft functioned well. Fourteen days after surgery, IVIg was administered at a dose of 1 g/kg per day for 2 days to further reduce allosensitization. No immediate acute toxic reactions were noted. Two days later, the creatinine levels had increased to 2.2 mg/dL. A biopsy showed that thromboembolisms had formed in the glomeruli along with focal segmental mesangiolysis (Fig. 1). Four days later, the patient experienced severe graft pain. The serum creatinine concentration had increased to 3.