Date: Saturday, April 29, 2017
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
Pretransplant desensitization with rituximab has contributed to drastic improvements in ABO-incompatible renal transplantation (ABO-I). However, ABO-I outcomes are still worse than those of ABO-identical or ABO-compatible renal transplantation (ABO-Id/C).
We retrospectively examined the outcomes and complications in consecutive living donor ABO-Id/C (n = 412) and ABO-I (n = 205) cases to elucidate the causes of inferiority in ABO-I. ABO-I cases included recipients treated with rituximab (RIT, n = 131), splenectomy (SPX, n = 21), or neither because of low anti-A/B antibody titers (NoR/S, n = 53). Graft survival, infection, and de novo HLA antibody production were compared for ABO-I and ABO-Id/C, followed by stratification into RIT and NoR/S groups. Propensity score-based methods were employed to limit selection bias and potential confounders.
Overall graft survival for ABO-I was significantly lower than that for ABO-Id/C (92.8% vs 97.2% after five years, P = 0.0037). Graft loss due to infection with ABO-I was significantly more frequent than that with ABO-Id/C, whereas acute antibody-mediated rejection caused no graft failure in ABO-I recipients. Stratified analysis demonstrated that infection risk was significantly higher with RIT than with NoR/S.
Safe introduction and expansion of rituximab-avoidance pretreatment protocols might contribute to further improvement of ABO-I outcome.
CITATION INFORMATION: Okada M, Watarai Y, Iwasaki K, Murotani K, Hiramitsu T, Tsujita M, Goto N, Narumi S, Kobayashi T. Avoidance or Reduction of Rituximab Might Improve Clinical Outcomes in ABO-Incompatible Renal Transplantation: Advantages and Disadvantages of Rituximab. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Okada M, Watarai Y, Iwasaki K, Murotani K, Hiramitsu T, Tsujita M, Goto N, Narumi S, Kobayashi T. Avoidance or Reduction of Rituximab Might Improve Clinical Outcomes in ABO-Incompatible Renal Transplantation: Advantages and Disadvantages of Rituximab. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/avoidance-or-reduction-of-rituximab-might-improve-clinical-outcomes-in-abo-incompatible-renal-transplantation-advantages-and-disadvantages-of-rituximab/. Accessed January 20, 2020.
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