Development of De Novo Anti-HLA Antibodies after Treatment with/without Rituximab, a B Cell−Depleting Treatment
Urology, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, Japan
Meeting: 2013 American Transplant Congress
Abstract number: B1007
Background: Organ shortages have forced a widening of the indications for kidney donors. In Japan, ABO-incompatible kidney transplantation (ABOi) is a popular alternative to deceased kidney transplantations. In 2005, we started a rituximab protocol as a B cell-depleting therapy for immunological high-risk recipients, such as ABOi and HLA-incompatible cases. We examined the incidence rate of newly developed anti-HLA antibodies after transplantation and the characteristics of de novo antibodies, in patients with/without rituximab treatment.
Material and Methods: Between 2005 and 2012, a total of 579 recipients underwent kidney transplantations at our department and our affiliated hospitals; 313 recipients were treated without rituximab, and 266 recipients were treated with rituximab. We retrospectively investigated the development of de novo antibodies after kidney transplantation between recipients with and those without rituximab pre-treatment.
Results: De novo antibodies had developed in 27 of the 313 recipients without rituximab treatment (27/313, 9%) at 1141 days postoperatively and in 7 of the 266 recipients with rituximab treatment (7/266, 3%) at 601 days postoperatively. Of these patients with de novo antibodies, 7 of the 27 recipients treated without rituximab (7/27, 26%) and 1 of the 7 recipients treated with rituximab (1/7, 14%) lost their grafts. The de novo antibodies belonged to Class 2 in 24 of the 27 recipients treated without rituximab (24/27, 89%) and 6 of the 8 recipients treated with rituximab (6/8, 75%) The mean fluorescence intensities of the de novo antibodies were 6255 and 4902 in the patients treated without and those treated with rituximab, respectively (P=NS). The overall graft survival rates were 98% and 100% for patients treated without and those treated with rituximab. Conclusion: De novo antibody development seemed to be slightly less frequent among patients treated with rituximab, compared with patients treated without rituximab. Most of the de novo antibodies were Class 2, regardless of rituximab treatment. No significant differences in the timing of antibody appearance, the mean fluorescence intensity of the antibodies, or the graft survival rate were seen between the treatment groups. A rituximab protocol might be suitable for suppressing newly developed anti-HLA antibodies after renal transplantation.
To cite this abstract in AMA style:
Sawada Y, Ishida H, Omoto K, Nozaki T, Shimizu T, Inui M, Tanabe K. Development of De Novo Anti-HLA Antibodies after Treatment with/without Rituximab, a B Cell−Depleting Treatment [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/development-of-de-novo-anti-hla-antibodies-after-treatment-withwithout-rituximab-a-b-celldepleting-treatment/. Accessed May 14, 2025.« Back to 2013 American Transplant Congress