{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:11:56Z","timestamp":1761743516325},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2011,6,15]],"date-time":"2011-06-15T00:00:00Z","timestamp":1308096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:p>Roberti I, Geffner S, Vyas S. Successful rescue of refractory acute antibody\u2010mediated renal allograft rejection with splenectomy \u2013 A case report. \u2028Pediatr Transplantation 2012: 16: E49\u2013E52. \u00a9 2011 John Wiley &amp; Sons A\/S.<\/jats:p><jats:p><jats:bold>Abstract:\u2002<\/jats:bold> Highly sensitized patients receive fewer kidney transplants and have a high risk for severe rejection with increased rates of graft loss. We present a highly sensitized child who after desensitization protocol received a kidney transplant and developed refractory acute antibody\u2010mediated rejection. He failed to respond to standard therapy and needed an urgent splenectomy as rescue therapy. Our patient, an 18\u2010yr\u2010old AA male with ESRD due to obstructive uropathy received a second DD transplant. The allograft functioned immediately with SCr 1.4\u2003mg\/dL on day #5. On day #8, he was re\u2010admitted with fever, oligoanuria, and renal failure. He was started on methylprednisolone pulse, thymoglobulin, intravenous immunoglobulin, and PP. The transplant kidney biopsy revealed features suggestive of acute AMR. On day #14, the patient remained dialysis dependent with no response to therapy. He underwent an urgent splenectomy and a slow increase in urine output and GFR was noted. The SCr one\u2003month post\u2010splenectomy was 1.1\u2003mg\/dL. At one\u2003yr post\u2010txp, his GFR remained stable with SCr 0.9\u2003mg\/dL on tacrolimus, mycophenolate mofetil, and prednisone. Urgent splenectomy successfully reversed refractory acute AMR, in our highly sensitized patient with second renal transplant.<\/jats:p>","DOI":"10.1111\/j.1399-3046.2011.01518.x","type":"journal-article","created":{"date-parts":[[2011,6,15]],"date-time":"2011-06-15T08:29:44Z","timestamp":1308126584000},"source":"Crossref","is-referenced-by-count":12,"title":["Successful rescue of refractory acute antibody\u2010mediated renal allograft rejection with splenectomy \u2013 A case report"],"prefix":"10.1111","volume":"16","author":[{"given":"Isabel","family":"Roberti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart","family":"Geffner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shefali","family":"Vyas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,6,15]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01521.x"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707894"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200103150-00013"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01686.x"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000060252.57111.AC"},{"key":"e_1_2_5_7_2","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1681\/ASN.V133779","article-title":"Acute humoral rejection in kidney transplantation: II. 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