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Tocilizumab for antibody-mediated rejection treatment in lung transplantation

Spenser E January1, Keith A Fester1, Laura P Halverson2

  • 1Department of Pharmacy, Barnes-Jewish Hospital , Saint Louis, Missouri.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|June 2, 2023
PubMed

Tocilizumab (TCZ), an IL-6 inhibitor, has shown promise in the treatment of donor-specific antibodies (DSA) and chronic antibody-mediated rejection (AMR) in renal transplant recipients. However, its use in lung transplantation has not been described. This retrospective case-control study compared AMR treatments containing TCZ in 9 bilateral lung transplant recipients to 18 patients treated for AMR without TCZ. Treatment with TCZ resulted in more clearance of DSA, lower recurrence of DSA, lower incidence of new DSA, and lower rates of graft failure when compared to those treated for AMR without TCZ. The incidence of infusion reactions, elevation in transaminases, and infections were similar between the 2 groups. These data support a role for TCZ in pulmonary AMR and establish preliminary evidence to design a randomized controlled trial of IL-6 inhibition for the management of AMR.

Keywords:
antibody-mediated rejectiondonor-specific antibodiesinterleukin-6 inhibitionlung transplantationtocilizumab

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