Course of Donor Specific Anti-HLA Antibodies After Induction Therapy with Rituximab in Renal Transplantation.
1Nephrology, Radboud University Medical Center, Nijmengen, Netherlands
2Blood Transfusion and Transplantation Immunology, Radboud University Medical Center, Nijmegen, Netherlands
3Internal Medicine, Division of Nephrology and Kidney Transplantation, Erasmus MC, University Medical Center, Rotterdam, Netherlands
Meeting: 2017 American Transplant Congress
Abstract number: B172
Keywords: Sensitization
Session Information
Session Name: Poster Session B: Kidney Immunosuppression: Induction Therapy
Session Type: Poster Session
Date: Sunday, April 30, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
The presence of pre-existing or de novo donor-specific antibodies against HLA (DSA), is associated with a worse graft outcome after renal transplantation. B-cell depletion protocols have shown to reduce DSA and chronic antibody mediated rejection. We aimed to study the effects of rituximab as a single-agent induction therapy on pre-existent or de novo DSA after renal transplantation.
We collected sera in participants of a prospective double-blind randomized study on the effect of the prophylactic use of rituximab, added to standard immunosuppressive treatment (prednisolone, tacrolimus and mycophenolate mofetil) in comparison with standard immunosuppressive treatment alone in renal transplantation (NCT00565331). 280 patients were included in this trial (142 received placebo, 138 rituximab). Serum before transplantation and at 12 months after transplantation was available in 127 placebo and 119 rituximab treated patients (total 246 patients).
At the moment of transplantation, 12.6% of placebo- and 8.4% of rituximab treated patients had anti-HLA class 1 antibodies. Pre-existent class 1 DSA were present in 7/127 (5.5%) placebo- and 5/119 (4.2%) rituximab treated patients (NS). In both groups all class 1 DSA disappeared at month 12 after transplantation.
Anti-HLA class 2 antibodies were present in 9.4% of placebo- and 8.4% of rituximab treated patients at the time of transplantation. Pre-existent class 2 DSA were present in 6/127 (4.7%) placebo- and 1/119 (0.8%) rituximab treated patients (NS). In the placebo group, class 2 DSA disappeared in 3 patients and persisted in the other 3. Class 2 DSA persisted in the patient treated with rituximab
2/127 (1.6%) placebo- and 2/119 (1.7%) rituximab treated patients developed de novo class 1 DSA (NS).
De novo class 2 DSA developed in 7/127 (5.5%) placebo-treated patients at 12 months and in only 1 patient treated with rituximab (0.8%, p = 0.04).
In conclusion, pre-existent class 1 DSA disappeared at 12 months after transplantation independent of rituximab induction therapy. Pre-existent class 2 DSA are less likely to disappear. Although only very few patients developed de novo DSA, rituximab induction therapy might inhibit the formation of de novo class 2 DSA.
CITATION INFORMATION: Baas M, Allebes W, van den Hoogen M, Joosten I, Hilbrands L. Course of Donor Specific Anti-HLA Antibodies After Induction Therapy with Rituximab in Renal Transplantation. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Baas M, Allebes W, Hoogen Mvanden, Joosten I, Hilbrands L. Course of Donor Specific Anti-HLA Antibodies After Induction Therapy with Rituximab in Renal Transplantation. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/course-of-donor-specific-anti-hla-antibodies-after-induction-therapy-with-rituximab-in-renal-transplantation/. Accessed May 12, 2025.« Back to 2017 American Transplant Congress