Pretransplant Use of Rituximab is Associated with Posttransplant Malignancies Events and Death by Neoplasia in Incompatibility Living Donor Kidney Transplants
1Renal Transplant Unit. Department of Nephrology and Kidney Transplant. Hospital Clinic, Barcelona, Spain
2Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
3REDINREN, Madrid, Spain
4Barcelona University, Barcelona, Spain
5Dipartamento di Epidemiologia e Ricerca Pre-Clinica. IRCCC, Roma, Italy
6Department of Apheresis. Hospital Clinic, Barcelona, Spain
7Department of Immunology. Hospital Clinic, Barcelona, Spain.
Meeting: 2018 American Transplant Congress
Abstract number: B356
Keywords: CD20, Immunoadsorption, Malignancy
Session Information
Session Name: Poster Session B: PTLD/Malignancies: All Topics
Session Type: Poster Session
Date: Sunday, June 3, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Introduction: Incompatibilities is a challenge in kidney transplantation. Potent immunosuppression approach based on desensitization protocols (DS) are usually needed; However, controversies in results and lack information in safety profile related to cancer risk are not well docummented. Our aim lays in to study the incidence and behaviour of posttransplant malignancies (PTM) in kidney transplant patients under DS.
Method: Living Donor Kidney transplants (LDKT, 2006-2015) were enrolled. Incompatible patients receiving rituximab with or without plasma exchange/immunoadsortion and IGIV were comparing with compatible LDKT. All patients signed inform consent, and the study was approved by the Ethics Committee of our Institution.
Results: 105 of 486 LDKT received DS due to ABO incompatibility (66), Positive crossmatch (33), Both (4), or other (2). Same patient survival, but more acute rejection (p=0.001), graft loss (p=0.025), ethiology of CKD (p= 0.009), and induction therapy (p=0.001) were associated with DS. However, DS was not associated with PTM, graft loss due to cancer, either death by neoplasia. The risk factors for PTM (77 PTM in 42 patients (8.6%): 51 NMSC (16 patients), 21 SOT, 4 PTLD, and 1 KS) were age at transplant (p=0.031), de novo CNI (p=0.10), and worse renal function (p<0.05). And neoplasia was associated with patient survival (p=0.000), as well as de novo CNI de novo (p=0.039),CNI at-tumor (P=0.043), and smoking habbit (p=0.01). DS, induction therapy or mTOR inhibitors were not associated with neoplasia or death of the patient. However, pretransplant Rituximab use and doses were associated significantly with episodes of PTM (p=0.028) and death by neoplasia (p=0.000).
Conclusion: DS is not associated with PTN; however, the use of rituximab doses in a DS protocol in incompatibility LDKT is associated with the number of PTM, and death by neoplasia.
CITATION INFORMATION: Revuelta I., Tubita V., Cucchiari D., De Sousa E., Piselli P., Lozano M., Cid J., Palou E., Martorell J., Oppenheimer F., Diekmann F., Campistol J. Pretransplant Use of Rituximab is Associated with Posttransplant Malignancies Events and Death by Neoplasia in Incompatibility Living Donor Kidney Transplants Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Revuelta I, Tubita 4V, Cucchiari D, Sousa EDe, Piselli P, Lozano M, Cid J, Palou E, Martorell J, Oppenheimer F, Diekmann 4F, Campistol1 4J. Pretransplant Use of Rituximab is Associated with Posttransplant Malignancies Events and Death by Neoplasia in Incompatibility Living Donor Kidney Transplants [abstract]. https://atcmeetingabstracts.com/abstract/pretransplant-use-of-rituximab-is-associated-with-posttransplant-malignancies-events-and-death-by-neoplasia-in-incompatibility-living-donor-kidney-transplants/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress