We present an exceptional case of a lung transplant recipient successfully treated by multiple courses of alemtuzumab for refractory acute cellular rejection (ACR). The patient experienced multiple episodes of ACR following the transplantation procedure. Alemtuzumab was initiated as a third-line rejection treatment and was repeated 6 times. Each treatment course resulted in complete recovery of the pulmonary function and depletion of T- and B-lymphocytes and natural killer cells (NK cells). The onset of rejection was consistently preceded by the recovery of NK cells, while T- and B-lymphocytes remained depleted. This suggests a rejection process mediated by NK cells. This case contributes to recent research findings suggesting that NK cells play a significant role in ACR in lung transplant recipients and stresses the importance to further investigate the role of NK cells in rejection. Furthermore, it demonstrates that ACR following lung transplantation can be repeatedly managed by treatment with alemtuzumab.

中文翻译：

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肺移植后阿仑单抗复发性急性细胞排斥反应。


我们介绍了一个特殊的案例，即肺移植受者通过多个疗程的阿仑单抗成功治疗难治性急性细胞排斥反应 （ACR）。患者在移植手术后经历了多次 ACR 发作。Alemtuzumab 作为三线排斥治疗开始，重复 6 次。每个疗程都导致肺功能完全恢复，并耗竭 T 淋巴细胞和 B 淋巴细胞以及自然杀伤细胞 （NK 细胞）。排斥反应的发生始终发生在 NK 细胞的恢复之前，而 T 淋巴细胞和 B 淋巴细胞仍然耗尽。这表明 NK 细胞介导的排斥过程。该病例有助于最近的研究结果表明 NK 细胞在肺移植受者的 ACR 中起重要作用，并强调了进一步研究 NK 细胞在排斥反应中的作用的重要性。此外，它表明肺移植后的 ACR 可以通过阿仑单抗治疗来反复控制。