American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Which treatment options might be used for humoral acute rejection?

1. Corticosteroids

2. Plasmapheresis and IVIG

3. Monoclonal antibody therapy

4. Conventional chemotherapy

The correct answer is: Plasmapheresis and IVIG

Humoral acute rejection in organ transplantation is characterized by the production of antibodies against donor antigens, leading to vessel damage and organ dysfunction. The correct treatments for this condition aim to remove circulating antibodies and dampen the immune response. Plasmapheresis is a procedure that filters the blood to remove antibodies from the plasma, effectively reducing the levels of these harmful antibodies. Intravenous immunoglobulin (IVIG) can also be administered to help modulate the immune system and further decrease the effects of the antibodies. Together, these therapies are particularly effective in addressing humoral rejection by directly targeting the underlying mechanism of antibody-mediated injury. Other treatment options, while they may be utilized in different contexts of rejection or to manage overall immunosuppression, do not specifically address the issue of humoral acute rejection as directly as plasmapheresis and IVIG do. Corticosteroids primarily suppress T-cell activity and may not be sufficient for managing antibody-mediated rejection. Monoclonal antibody therapy can also play a role but is not as targeted directly for the acute humoral response as plasmapheresis combined with IVIG. Conventional chemotherapy is not relevant in this context since it targets rapidly dividing cells and is not an effective treatment for antibody-mediated conditions.