Refractory antibody-mediated rejection after high-emergency lung transplantation for dermatomyositis with anti-MDA5 antibody: a case report
This case report describes a female with amyopathic anti-MDA5+ dermatomyositis who underwent emergency double lung transplantation due to rapidly progressive interstitial lung disease. Following transplantation, she developed acute antibody-mediated rejection (AMR). Despite multiple rounds of immunosuppressive therapy, her condition continued to deteriorate, and her donor-specific anti-human leukocyte antigen antibody levels increased markedly. An experimental treatment, imlifidase-an immunoglobulin G endopeptidase-was employed as a rescue therapy. This case highlights the complexity of posttransplant management of AMR and emphasizes the need for dedicated clinical trials to provide additional data.
Authors
- Domitille Mouren (ORCID: https://orcid.org/0000-0002-4134-4737)
- Brice Lortat‐Jacob (ORCID: https://orcid.org/0000-0001-7182-3678)
- Yves Allenbach (ORCID: https://orcid.org/0000-0002-3185-7993)
- Y. Uzunhan (ORCID: https://orcid.org/0000-0002-1607-1407)
- Cloé Comarmond (ORCID: https://orcid.org/0000-0002-0990-8213)
- Jean‐Luc Taupin (ORCID: https://orcid.org/0000-0002-5766-046X)
- Aurélie Cazes (ORCID: https://orcid.org/0000-0002-7172-9101)
- Cendrine Godet (ORCID: https://orcid.org/0000-0002-9627-3016)
- Vincent Bunel (ORCID: https://orcid.org/0000-0002-5080-6331)
- Jean Alexandre (ORCID: https://orcid.org/0000-0003-3499-7534)
- Mathilde Salpin (ORCID: https://orcid.org/0000-0002-0110-1589)
- Jonathan Messika (ORCID: https://orcid.org/0000-0003-2123-3527)
- G. Weisenburger (ORCID: https://orcid.org/0000-0002-1357-9686)
- Pierre Mordant (ORCID: https://orcid.org/0000-0001-5716-4848)
- Raphaël Borie (ORCID: https://orcid.org/0000-0002-9906-0024)
- Hervé Mal (ORCID: https://orcid.org/0000-0002-5951-436X)
- Antoine Roux (ORCID: https://orcid.org/0000-0003-2387-0669)
- Louise Chantelot
Institutions
- Université Claude Bernard Lyon 1 (FR)
- Délégation Paris 7 (FR)
- Université Paris Cité (FR)
- Sorbonne Université (FR)
- Université Sorbonne Paris Nord (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Hôpital Lariboisière (FR)
- Pitié-Salpêtrière Hospital (FR)
- Hôpital Avicenne (FR)
- Hôpital Saint-Louis (FR)
- Hôpital Bichat-Claude-Bernard (FR)
- Hôpital Foch (FR)
Publication Details
- Journal
- Clinical Transplantation and Research
- Published
- 2025-10-01
- DOI
- https://doi.org/10.4285/ctr.25.0034
- Primary Topic
- Inflammatory Myopathies and Dermatomyositis
- Type
- article
- Field-Weighted Citation Impact
- 0.00