ABO-Incompatible Kidney Transplantation Using Antigen-Specific Immunoadsorption and Rituximab: A 3-Year Follow-up

Abstract

We conclude that ABOi kidney transplantation using antigen-specific immunoadsorption and rituximab is equivalent to ABOc living donor kidney transplantation. ABOi transplantation after this protocol does not have a negative impact on long-term graft function.

Role of Rituximab Therapy in Glomerulonephritis

“…1,2 With the success of biologic agents, rituximab in particular, in autoimmune arthritis, multiple sclerosis, and transplantation, attention is turning to autoimmune renal disease. [3][4][5] Rituximab is a murine/human chimeric anti-CD20 mAb that depletes B cells and was licensed in 1997 for the treatment of non-Hodgkin's lymphoma. A subsequent expansion of interest in rituximab as an immunomodulatory agent resulted in a label for rheumatoid arthritis in 2006 and preliminary reports of efficacy across the spectrum of autoimmune disease.…”

AB0 nesuderinamumas neturi įtakos ankstyvam inkstų transplantato funkcionavimui po gyvų donorų organų transplantacijos

“…Vienas šios problemos sprendimo būdų -AB0n inkstų transplantacija. Tiek trumpalaikiai, tiek ilgalaikiai tokių pacientų stebėjimai parodė, kad AB0n protokolai, kombinuojant rituksimabą, donarui specifišką imunoadsorbciją bei trigubą imunosupresiją, tolygūs AB0 tapačių kraujo grupių transplantacijai, nepasireiškiant skirtumams tarp recipiento/alografto išgyvenamumo [2,3,4,5,6]. Šiame straipsnyje pateikiame duomenis apie 32 inkstų transplantacijas iš gyvų donorų, kurių 10 buvo netapačių kraujo grupių inksto transplantacijos.…”

Antibody immunosuppressive therapy in solid organ transplant

“…that single-dose rituximab significantly improved graft outcomes in ABO-incompatible patients and eliminated the need for cosurgical splenectomy (graft survival of 86.7% at 3 years mean follow up, equivalent to the graft survival in the ABO-compatible control group). 24 Attempting to broaden the spectrum of rituximab use, the same group recently conducted a prospective, double-blind, multicenter randomized trial comparing 68 kidney transplant patients treated with rituximab to 68 placebocontrolled patients. Rituximab or placebo was administered along with tacrolimus, mycophenolate mofetil and steroids.…”