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Right arrow Transplantation - heart

Ann Thorac Surg 2003;76:607-610
© 2003 The Society of Thoracic Surgeons

Case report

Methotrexate in acute persistent humoral rejection: an option for graft rescue

Fernando Bacal, MD*a, Gustavo L. Sodré, MDa, Daniela A. Fernandes, MDa, Vera D. Aiello, MDa, Noedir Stolf, MDa, Edimar Bocchi, MDa, Giovanni Bellotti, MDa

a Heart Failure Department, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil

Accepted for publication January 19, 2003.

* Address reprint requests to Dr Bacal, Rua João Castaldi, 217 Apto 42, Moema, São Paulo–SP 04517-050, Brazil
e-mail: fbacal{at}uol.com.br

Humoral response emerges as an important component in acute graft rejection and a new challenge to clinicians in posttransplant care. Management of recurrent episodes and persistent activation of the humoral component of the immune system, despite the usual therapeutic approach to rejection, remains unknown. This article describes the successful use of methotrexate as an option for rescuing a graft in this worrisome situation.






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