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Background <p>Myasthenia gravis (MG) is an autoimmune disease with the disorder of the neuromuscular junction, characterized by muscle weakness and easy fatigue. The disease is associated with the development of a myasthenic crisis caused by invasiveness or other factors. MG treatment includes immunosuppressants and blood purification therapy, similar to the immunosuppressive management in kidney transplantation (KTx). We performed KTx in patients with MG.</p> Case presentation <p>A female patient with chronic renal failure had already been diagnosed with MG, and she had been treated with tacrolimus (TAC) and methylprednisolone (MP). Immunoadsorption therapy was performed twice weekly along with hemodialysis therapy. At 57&#xa0;years of age, the patient underwent ABO-compatible, donor-specific antibody-positive living donor KTx. TAC, mycophenolate mofetil, MP, basiliximab, and rituximab were administered as immunosuppressants. Plasmapheresis and intravenous immunoglobulins were administered prior to KTx.</p> Conclusions <p>In addition to perioperative invasiveness, a postoperative urinary tract infection had occurred, raising concerns regarding the onset of a crisis. However, the impact of plasmapheresis and other immunosuppressive therapies may have had a positive influence on the perioperative management in this case.</p>

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Perioperative management of kidney transplantation in patients with myasthenia gravis: a case report with literature review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月20日

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  • Ayaka Saitoh,
  • Kohei Unagami,
  • Takahiro Inoue,
  • Yu Kijima,
  • Daigo Okada,
  • Miyuki Furusawa,
  • Kumiko Kitajima,
  • Toshihito Hirai,
  • Kazuya Omoto,
  • Tomokazu Shimizu,
  • Masashi Inui,
  • Junichi Hoshino,
  • Norio Hanafusa,
  • Toshio Takagi,
  • Hideki Ishida

摘要

Background

Myasthenia gravis (MG) is an autoimmune disease with the disorder of the neuromuscular junction, characterized by muscle weakness and easy fatigue. The disease is associated with the development of a myasthenic crisis caused by invasiveness or other factors. MG treatment includes immunosuppressants and blood purification therapy, similar to the immunosuppressive management in kidney transplantation (KTx). We performed KTx in patients with MG.

Case presentation

A female patient with chronic renal failure had already been diagnosed with MG, and she had been treated with tacrolimus (TAC) and methylprednisolone (MP). Immunoadsorption therapy was performed twice weekly along with hemodialysis therapy. At 57 years of age, the patient underwent ABO-compatible, donor-specific antibody-positive living donor KTx. TAC, mycophenolate mofetil, MP, basiliximab, and rituximab were administered as immunosuppressants. Plasmapheresis and intravenous immunoglobulins were administered prior to KTx.

Conclusions

In addition to perioperative invasiveness, a postoperative urinary tract infection had occurred, raising concerns regarding the onset of a crisis. However, the impact of plasmapheresis and other immunosuppressive therapies may have had a positive influence on the perioperative management in this case.