title: Effect of Pretransplant Rituximab Use on Posttransplant Clinical Outcomes in Patients with High Panel Reactive Antibody Scores.
abstract: OBJECTIVE
  Whether desensitization treatment is needed before kidney transplant (KT) in patients with high panel reactive antibody (PRA) scores but negative cross-matching (XM) tests remains controversial. This study aimed to investigate the effect of pretransplant rituximab (RTX) treatment on clinical outcomes in these patients.
  
  
  METHODS
  The study included 52 patients with PRA >50% but negative XM tests before transplantation. A single dose of RTX was administered before KT in 32 patients (RTX group). The 20 patients without RTX treatment were considered as controls (CON group). We compared the development of acute antibody-mediated rejection (AMR), rejection-free survival, allograft function, allograft and patients' survival rates and infection rates between the 2 groups.
  
  
  RESULTS
  The rate of acute AMR development was significantly lower in the RTX group than in the CON group (p = 0.009), and rejection-free survival in the RTX group was higher than in the CON group (p = 0.042). The 3-year graft and patient survival rates were higher in the RTX group than in the CON group (p = 0.007 and p = 0.037, respectively). There were no significant differences in infection rates between the groups.
  
  
  CONCLUSIONS
  Pretransplant use of RTX improved the post-transplant clinical outcomes in patients with high PRAs but negative XM tests.
authors.affiliation: Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Seun Deuk
authors.initials: SD
authors.lastname: Hwang
authors.forename: Byung Ha
authors.initials: BH
authors.lastname: Chung
authors.forename: Eun Jee
authors.initials: EJ
authors.lastname: Oh
authors.forename: Bum Soon
authors.initials: BS
authors.lastname: Choi
authors.forename: Cheol Whee
authors.initials: CW
authors.lastname: Park
authors.forename: Yong-Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Yang
mesh_terms: D000368:Aged; D000906:Antibodies / Q000032:analysis*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000453:epidemiology / Q000517:prevention & control; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011300:Preoperative Care; D000069283:Rituximab / Q000627:therapeutic use*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000906:Antibodies; D007166:Immunosuppressive Agents; D000069283:Rituximab