Impact of rituximab therapy for treatment of acute humoral rejection

Kaposztas, Z.; Podder, Hemangshu; Mauiyyedi, Shamila; Illoh, Orieji; Kerman, Ronald H.; Reyes, M; Pollard, V.; Kahan, B.D.

doi:10.1111/j.1399-0012.2008.00902.x

Cited by 117 publications

(91 citation statements)

References 38 publications

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“…The safety profile of RTX in this population remains unclear, however, with conflicting data on its association with infectious complications [3,[7][8][9][10][11][12][13][14]. This study of 55 kidney transplant patients treated with RTX for its common peri-and posttransplant indications favors an association an increased risk of infections with RTX.…”

Section: Discussionmentioning

confidence: 91%

“…T-lymphocyte depleting preparations in particular have been associated with an increased risk, as opposed to nonlymphocyte depleting agents which demonstrated similar infectious risks when compared to placebo [5,6]. RTX has generally been considered to have an acceptable safety profile in hematological and autoimmune disorders; however, whether it can be used without an increased risk of infectious complications remains controversial in the immunosuppressed population [3,[7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Effects of Rituximab on the Development of Viral and Fungal Infections in Renal Transplant Recipients

Patel

DeVos

Knight

et al. 2013

ISRN Transplantation

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Background. Rituximab is becoming increasingly utilized in renal transplant recipients; however, its association with infections remains unclear. Methods. We reviewed the incidence of viral and fungal infections in kidney transplant recipients treated with ( = 55) or without ( = 386) rituximab (RTX) in addition to standard immunosuppression. Results. Infections occurred in 134 (30%) patients, with a greater proportion in RTX versus no RTX patients (47% versus 28%; = 0.005). Viral infections occurred in 44% and 27% of RTX and no RTX patients, respectively ( = 0.012). This was largely driven by the frequency of BK viremia and noncytomegalovirus/non-BK viruses in RTX patients (27% versus 13% ( = 0.011) and 15% versus 2% ( < 0.001), resp.). Fungal infections also occurred more often in RTX patients (11% versus 3 %; = 0.009). Multivariate analysis revealed deceased donor recipient (odds ratio = 2.5; < 0.001) and rituximab exposure (odds ratio = 2.2; = 0.016) as independent risk factors for infection. Older patients, deceased donor recipients, those on dialysis longer, and those with delayed graft function tended to be at a greater risk for infections following rituximab. Conclusions. Rituximab is associated with an increased incidence of viral and fungal infections in kidney transplantation. Additional preventative measures and/or monitoring infectious complications may be warranted in those receiving rituximab.

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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Effects of Rituximab on the Development of Viral and Fungal Infections in Renal Transplant Recipients

Patel

DeVos

Knight

et al. 2013

ISRN Transplantation

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“…Recent data also report an anti-rejection activity of Rituximab (Kaposztas Z et al, 2009;Mulley WR et al 2009). …”

Section: Resultsmentioning

confidence: 99%

Post Transplant Lymphoproliferative Disorders After Liver Transplantation

Marino¹,

Aversa²,

Stragliotto³

et al. 2012

Liver Transplantation - Technical Issues and Complications

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“…13,14 Other strategies for managing ABMR include the use of rituximab, which targets pre-B cells and B cells, and bortezomib, which is a proteasome inhibitor. 15,16 Uncontrolled randomised studies have shown benefit in both rituximab and bortezomib. 11,17 These agents are usually used in conjunction with IVIG and/or PLEX.…”

Section: Discussionmentioning

confidence: 99%

Successful Salvage Treatment of Resistant Acute Antibody-Mediated Kidney Transplant Rejection with Eculizumab

Khan

Al-Riyami

Abed

et al. 2016

SQUMJ

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Antibody-mediated rejection (ABMR) jeopardises short-and long-term transplant survival and remains a challenge in the field of organ transplantation. We report the first use of the anticomplement agent eculizumab in Oman in the treatment of a 61-year-old female patient with ABMR following a living unrelated kidney transplant. The patient was admitted to the Sultan Qaboos University Hospital in Muscat, Oman, in 2013 on the eighth day post-transplantation with serum creatinine (Cr) levels of 400 µmol/L which continued to rise, necessitating haemodialysis. A biopsy indicated ABMR with acute cellular rejection. No improvement was observed following standard ABMR treatment and she continued to require dialysis. Five doses of eculizumab were administered over six weeks with a subsequent dramatic improvement in renal function. The patient became dialysis-free with serum Cr levels of 119 µmol/L within four months. This case report indicates that eculizumab is a promising agent in the treatment of ABMR.

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Impact of rituximab therapy for treatment of acute humoral rejection

Abstract: Addition of rituximab improved the outcomes of PP treatment of antibody mediated rejection episodes.

Cited by 117 publications

References 38 publications

Effects of Rituximab on the Development of Viral and Fungal Infections in Renal Transplant Recipients

Effects of Rituximab on the Development of Viral and Fungal Infections in Renal Transplant Recipients

Post Transplant Lymphoproliferative Disorders After Liver Transplantation

Successful Salvage Treatment of Resistant Acute Antibody-Mediated Kidney Transplant Rejection with Eculizumab

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