TABLE 1.
Our 5 cases with anti-donor A/B IgG titer ≥2048 in the era of rituximab
| Case | 1 | 2 | 3 | 4 | The present case |
|---|---|---|---|---|---|
| Transplant year | 2004 | 2006 | 2014 | 2016 | 2013 |
| Sex | F | M | F | F | M |
| Age | 58 | 65 | 66 | 51 | 58 |
| Combination of ABO blood type | A to O | AB to O | A to O | B to O | B to O |
| Initial anti-donor A/B IgG titer before rituximab | 2048 | 2048 | 2048 | 2048 | 8192 |
| Anti-donor A/B IgG titer just before LT | 128 | 32 | 128 | 128 | 64 |
| Number of pre-LT PEX sessions | 3 | 4 | 2 | 2 | 4 |
| Number of post-LT PEX sessions | 0 | 0 | 1 | 0 | 0 |
| Number of pre-LT rituximab doses | 1 | 1 | 1 | 1 | 2 |
| Number of post-LT rituximab doses | 0 | 0 | 0 | 1 | 0 |
| AST/ALT on PTD-3, U/L | 79/135 | 119/122 | 112/330 | 92/462 | 40/103 |
| AST/ALT on PTD-7, U/L | 88/151 | 139/290 | 66/145 | 13/55 | 25/68 |
| AST/ALT on PTD-14, U/L | 16/44 | 65/133 | 72/114 | 12/14 | 28/67 |
| AST/ALT on PTD-30, U/L | 15/15 | 56/80 | 50/81 | 14/31 | 17/18 |
| AST/ALT on PTD-90, U/L | 25/33 | 51/27 | 21/16 | 17/13 | 15/35 |
| AMR | No | No | No | No | No |
| Blood culture positivity | No | No | No | No | Pseudomonas aeruginosa on PTD-7, cured with MEPM |
| CMV antigen positivity | Positive on day 28, cured by antivirals | Positive on day 52, cured by antivirals | No | Positive on day 33, cured by antivirals | Positive on day 24, cured by antivirals |
| Latest anti-donor A/B IgG titer | 64 | 64 | 64 | 2 | 4 |
ALT, alanine aminotransferase; AMR, antibody-mediated rejection; AST, aspartate aminotransferase; CMV, cytomegalovirus; F, female; LT, liver transplantation; M, male; MEPM, Meropenem; PEX, plasma exchange; PTD, post-transplant day.