Subcutaneous Alemtuzumab as Salvage Therapy for Acute Kidney Transplant Rejection Following Thymoglobulin Anaphylaxis: A Pediatric Case Report.
Kevin W O'Connor, Serena Bagnasco, Cozumel Pruette et al.
✦ AI-curated · Sources linked
Case in brief
A 12-year-old male with end-stage kidney disease due to congenital renal dysplasia underwent kidney transplantation and presented 9 years later with acute allograft dysfunction. Evaluation revealed elevated serum creatinine and a kidney biopsy showed Banff grade IIA T-cell-mediated rejection. After anaphylaxis to rabbit anti-thymocyte globulin, the patient was treated with subcutaneous alemtuzumab, resulting in significant improvement in kidney function and stable graft status at follow-up.
Diagnostic / clinical pearl
Alemtuzumab may serve as an effective alternative to rATG for treating acute rejection in pediatric kidney transplant recipients when rATG is contraindicated.
Why it matters
This case underscores the need for alternative immunosuppressive strategies in pediatric transplant patients, particularly in the context of anaphylaxis to standard therapies.