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Association between response to rituximab and antibody-mediated rejection in ABO-incompatible living kidney transplantation.
- Source :
-
International journal of urology : official journal of the Japanese Urological Association [Int J Urol] 2019 Dec; Vol. 26 (12), pp. 1114-1120. Date of Electronic Publication: 2019 Sep 14. - Publication Year :
- 2019
-
Abstract
- Objectives: To examine the association of response to rituximab and the incidence of antibody-mediated rejection in preconditioning of rituximab and plasma exchange without post-transplant plasmapheresis in patients undergoing ABO-incompatible living kidney transplantation.<br />Methods: A total of 115 patients who underwent ABO-incompatible living kidney transplantation at Tokyo Women's Medical University Hospital, Tokyo, Japan, were divided into two groups based on the response to rituximab: good response (n = 75) or poor response (n = 40). The rituximab good response and poor response patients were defined as patients whose CD19 <superscript>+</superscript> cells were non-detected (0%) and detected on the day of transplantation (2-5 days, median 3 days, after rituximab administration), respectively.<br />Results: Rituximab response and anti-A/B blood antibody titer after plasmapheresis were significant risk factors for antibody-mediated rejection (P = 0.036, 0.045, respectively). The occurrence of antibody-mediated rejection was higher in the poor response group than in the good response group (22.5% vs 8.0%; P = 0.028). The 14-day, 3-month and 1-year cumulative incidence of antibody-mediated rejection was 2.7%, 5.3% and 8.0% in the good response group, and 17.5%, 20.0% and 22.5% in the poor response group after ABO-incompatible living kidney transplantation. The patient survival was not significantly different between the two groups. However, graft survival 1 month after transplantation was lower in the poor response group. There is no significant difference in graft function and in the incidence of complications, including infection, after transplantation between the two groups.<br />Conclusions: Antibody-mediated rejection after ABO-incompatible living kidney transplantation was significantly associated with the response to rituximab in our preconditioning protocol.<br /> (© 2019 The Japanese Urological Association.)
- Subjects :
- ABO Blood-Group System
Adult
Aged
Allografts immunology
Allografts pathology
Biopsy
Blood Group Incompatibility blood
Blood Group Incompatibility immunology
Female
Follow-Up Studies
Graft Rejection blood
Graft Rejection immunology
Graft Rejection prevention & control
Graft Survival drug effects
Graft Survival immunology
Humans
Incidence
Japan epidemiology
Kidney immunology
Kidney pathology
Living Donors
Male
Middle Aged
Plasma Exchange
Retrospective Studies
Risk Assessment
Transplantation Conditioning methods
Treatment Outcome
Blood Group Incompatibility therapy
Graft Rejection epidemiology
Immunosuppressive Agents therapeutic use
Kidney Transplantation adverse effects
Rituximab therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1442-2042
- Volume :
- 26
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- International journal of urology : official journal of the Japanese Urological Association
- Publication Type :
- Academic Journal
- Accession number :
- 31522467
- Full Text :
- https://doi.org/10.1111/iju.14108