Impact of pretransplant rituximab induction on highly sensitized kidney recipients: Comparison with non-rituximab group

Young Hae Song, Kyu Ha Huh, Yu Seun Kim, Hyung Soon Lee, Myoung Soo Kim, Soo Jin Kim, Hyun Jung Kim, Soon Il Kim, Dong Jin Joo

Research output: Contribution to journalArticle

4 Citations (Scopus)

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 ≥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.

Original languageEnglish
Pages (from-to)335-339
Number of pages5
JournalJournal of the Korean Surgical Society
Volume82
Issue number6
DOIs
Publication statusPublished - 2012 Jun 1

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Kidney
Antibodies
Transplantation
Rituximab
Graft Survival
Immunosuppressive Agents
Dialysis
Anti-Idiotypic Antibodies
B-Lymphocytes
Monoclonal Antibodies
Demography

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Song, Young Hae ; Huh, Kyu Ha ; Kim, Yu Seun ; Lee, Hyung Soon ; Kim, Myoung Soo ; Kim, Soo Jin ; Kim, Hyun Jung ; Kim, Soon Il ; Joo, Dong Jin. / Impact of pretransplant rituximab induction on highly sensitized kidney recipients : Comparison with non-rituximab group. In: Journal of the Korean Surgical Society. 2012 ; Vol. 82, No. 6. pp. 335-339.
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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 ≥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.",
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Impact of pretransplant rituximab induction on highly sensitized kidney recipients : Comparison with non-rituximab group. / Song, Young Hae; Huh, Kyu Ha; Kim, Yu Seun; Lee, Hyung Soon; Kim, Myoung Soo; Kim, Soo Jin; Kim, Hyun Jung; Kim, Soon Il; Joo, Dong Jin.

In: Journal of the Korean Surgical Society, Vol. 82, No. 6, 01.06.2012, p. 335-339.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of pretransplant rituximab induction on highly sensitized kidney recipients

T2 - Comparison with non-rituximab group

AU - Song, Young Hae

AU - Huh, Kyu Ha

AU - Kim, Yu Seun

AU - Lee, Hyung Soon

AU - Kim, Myoung Soo

AU - Kim, Soo Jin

AU - Kim, Hyun Jung

AU - Kim, Soon Il

AU - Joo, Dong Jin

PY - 2012/6/1

Y1 - 2012/6/1

N2 - 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 ≥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.

AB - 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 ≥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.

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