Evaluation of low-dose rituximab induction therapy in living related kidney transplantation.
BACKGROUND
Rrituximab has been used for desensitization of anti-blood type antibody and anti-human leukocyte antigen (HLA) antibody as an induction immunosuppressant in our hospital. After having used rituximab for more than 2 years, we performed a retrospective study to clarify the effectiveness and safety of rituximab.


METHODS
We performed 144 kidney transplants between January 2005 and December 2007 at our hospital. Low-dose rituximab was administered to 78 of these transplant recipients as an induction immunosuppressant. A comparison of viral infection, leucopenia, and rejection incidence between patients administered (Rit group) and not administered (Non-Rit group) rituximab before kidney transplantation was performed.


RESULTS
A comparison of Rit group and Non-Rit group revealed no significant difference in the incidence of cytomegalovirus infections (Rit: 26%, Non-Rit: 29%; P=1.00), BK virus infections (Rit: 2.6%, Non-Rit: 0%; P=0.53), or leukopenia (Rit:23%, Non-Rit: 14%; P=0.25) between the two groups of patients. The incidence of acute antibody-mediated rejection was also not significantly different between the two groups (Rit: 6.8%, Non-Rit: 8.3%; P=0.75). On the other hand, the incidence of acute T-cell-mediated rejection was significantly lower in the Rit group (Rit: 8.2%, Non-Rit: 23.3%; P<0.05). Anti-HLA antibodies belonging to HLA class 1 and class 2 were depleted by 70% and 83%, respectively, for more than 2 years after rituximab administration.


CONCLUSIONS
We could confirm the effectiveness and safety of rituximab more than 2-year follow-up period.
Takagi
Toshio
T
Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.
Ishida
Hideki
H
Shirakawa
Hiroki
H
Shimizu
Tomokazu
T
Tanabe
Kazunari
K
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology / Q000379:methods*; D007970:Leukopenia / Q000473:pathology; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000069283:Rituximab; D016896:Treatment Outcome; D005719:gamma-Globulins / Q000378:metabolism
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D006680:HLA Antigens; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D005719:gamma-Globulins; D000069283:Rituximab