Clinical efficacy of rituximab for acute rejection in kidney transplantation: a meta-analysis.
OBJECTIVE
This meta-analysis was undertaken to compare the efficacy and safety of pretransplant treatment with rituximab in sensitized patients receiving kidney transplantation.


METHODS
PubMed, EMBASE, and Cochrane databases were searched to identify studies that used pretransplantation rituximab in eligible patients. The major outcomes included antibody-mediated rejections (AMR) after kidney transplantation and one-year graft survival rate. The meta-analysis was performed using fixed-effects model.


RESULTS
Seven studies were identified including a total of 589 patients, of whom 312 were treated without rituximab, while 277 were treated with rituximab. In our meta-analysis, patients treated with rituximab had significantly fewer AMR after kidney transplantation [odds ratio (OR) 0.52, 95 % CI 0.28, 0.98, P = 0.04] and higher rate of one-year graft survival rates (OR 3.02, 95 % CI 1.14, 8.02, P = 0.03), indicating that rituximab is effective against acute rejection and enhances graft survival in kidney transplantation. No differences were noted in other efficacy and safety parameters in these two patient groups.


CONCLUSIONS
We demonstrated that preinduction with rituximab could significantly improve AMR and graft survival rates in sensitized patients undergoing kidney transplantation. Future prospective controlled studies are warranted to further understand rituximab's role in kidney transplantation.
Organ Transplantation Institute of People's Liberation Army, 309th Hospital of Chinese People's Liberation Army, Heishanhu Road, Haidian District, Beijing, 100091, China.
Yu-Gang
YG
Zhao
Bing-Yi
BY
Shi
Ye-Yong
YY
Qian
Hong-Wei
HW
Bai
Li
L
Xiao
Xiu-Yun
XY
He
D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000627:therapeutic use*; D006084:Graft Rejection / Q000188:drug therapy*; D006085:Graft Survival; D006801:Humans; D056724:Immunity, Humoral; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D016030:Kidney Transplantation; D000069283:Rituximab; D015996:Survival Rate
D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab