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Dialyse aktuell 2020; 24(08): 302-308
DOI: 10.1055/a-1169-8340
Schwerpunkt
Transplantation
© Georg Thieme Verlag Stuttgart · New York

Herausforderungen in der Behandlung später antikörpermediierter Abstoßung

Was sind die relevanten Aspekte bei Nierentransplantation?
Farsad-Alexander Eskandary
1   Klinische Abteilung für Nephrologie und Dialyse, Univ.-Klinik für Innere Medizin III, Medizinische Universität Wien, Wien (Österreich)
,
Georg A. Böhmig
1   Klinische Abteilung für Nephrologie und Dialyse, Univ.-Klinik für Innere Medizin III, Medizinische Universität Wien, Wien (Österreich)
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
12. Oktober 2020 (online)

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ZUSAMMENFASSUNG

Derzeit gibt es keine Behandlung, die nachweislich in der späten und/oder chronischen antikörpervermittelten Abstoßung (ABMR) wirksam ist. Für Bortezomib und die kombinierte Anwendung von intravenösen Immunglobulinen (IVIG)/Rituximab haben doppelblinde randomisiert-kontrollierte Studien (RCTs) keine signifikante Wirkung auf deren Progression nachgewiesen. Der Antikörper Eculizumab konnte in einer kontrollierten Pilotstudie keine oder nur marginale klinische Wirkungen zeigen. Die größte Hoffnung stellen derzeit Therapien dar, welche die IL-6/IL-6R-Achse (IL-6R: Interleukin-6-Rezeptor) blockieren oder in der Lage sind, CD38-positive Zellen wie Plasma- und natürliche Killer-Zellen (NK-Zellen) zu depletieren.

 

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