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KMID : 0361120170310010052
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Korean Journal of Transplantation
2017 Volume.31 No. 1 p.52 ~ p.57
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Fatal Invasive Pulmonary Aspergillosis after Combined Induction with Rituximab and Antithymocyte Globulin for Kidney Transplantation in a Sensitized Recipient, and Early Rejection Therapy with Plasmapheresis and Low-dose Immunoglobulin
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Jeong Da-Wun
Lee Sang-Hoon
Kim Yang-Gyun
Lee Yu-Ho
Kim Ki-Pyo
Park Ho-Chul
Joo Sun-Hyung
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Abstract
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A high degree of sensitization to human leukocyte antigen requires more intensive induction therapy; however, this increases vulnerability to opportunistic infections following kidney transplantation. Although recent studies have suggested that combined induction therapy with antithymocyte globulin and rituximab would be more effective in highly sensitized kidney recipients, we experienced a case of near-fatal invasive pulmonary aspergillosis 2 months after combined induction and early rejection therapy for graft dysfunction. Fortunately, the patient recovered with intensive antifungal treatment and lung lobectomy for a necrotic cavity. Antifungal prophylaxis should be considered in cases undergoing intensive induction therapy.
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KEYWORD
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Invasive pulmonary aspergillosis, Combined desensitization induction, Kidney transplantation
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