Impact of pretransplant rituximab induction on highly sensitized kidney recipients: comparison with non-rituximab group.
10.4174/jkss.2012.82.6.335
- Author:
Young Hae SONG
1
;
Kyu Ha HUH
;
Yu Seun KIM
;
Hyung Soon LEE
;
Myoung Soo KIM
;
Soo Jin KIM
;
Hyun Jung KIM
;
Soon Il KIM
;
Dong Jin JOO
Author Information
1. Department of Surgery, Yonsei University Health System, Seoul, Korea. djjoo@yuhs.ac
- Publication Type:Original Article
- Keywords:
Kidney transplantation;
Immunological sensitization;
Rituximab
- MeSH:
Antibodies, Monoclonal, Murine-Derived;
B-Lymphocytes;
Cohort Studies;
Demography;
Dialysis;
Graft Survival;
Humans;
Immunization;
Kidney;
Kidney Transplantation;
Rejection (Psychology);
Rituximab;
Transplants
- From:Journal of the Korean Surgical Society
2012;82(6):335-339
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Highly sensitized patients with a high level of panel reactive antibody (PRA) experience more episodes of antibody-mediated rejection (AMR) and poorer graft survival than non-sensitized patients. Rituximab is a well-known monoclonal anti-CD20 antibody that causes the depletion of B lymphocytes. The aim of this study was to compare a rituximab-administered and a non-administered group of highly sensitized recipients. METHODS: Forty-three kidney recipients with a PRA level of > or =50% were included. Sixteen (group R) received one dose of rituximab at 2 days prior to transplantation and 27 patients (group NR) did not. RESULTS: Patients' demographics, such as age, sex, dialysis duration, and type of immunosuppressive agent were not different in the two groups. No side effects due to rituximab administration were observed in group R. Class I PRA of group R (75.6 +/- 37.7%) was higher than that of group NR (45.7 +/- 35.8%, P = 0.013). More acute rejection episodes occurred within 1 year after transplantation in group NR but the difference between the groups was not significant (18.8% in group R vs. 29.6% in group NR, P = 0.631). However, two AMR episodes occurred only in group NR. Renal functions were not different in the two groups. In group R, CD19 and CD20 rapidly decreased 2 days after rituximab infusion. Furthermore, the administration of rituximab was not linked to acute rejection. CONCLUSION: To confirm the long-term anti-rejection and beneficial effects of rituximab, further studies should be performed with a larger cohort. In conclusion, rituximab administration 2 days prior to transplantation is both effective and safe.
