Background The place of rituximab in the treatment of acute antibody-mediated rejection (ABMR) is still controversial. The French multicenter double-blind, placebo-controlled RITUX ERAH study included 38 patients with biopsy proven early ABMR in the first year of renal transplantation. All patients received plasma exchanges, IVIg, corticosteroids and randomized treatment by rituximab (375 mg/m[sup2]) or placebo at day 5. Additional infusions of rituximab were allowed. Graft survival and renal function were not different with rituximab or placebo at 1 year.

Methods Evaluation of the 5-year outcomes of the patients from the RITUX ERAH study according to the treatment received.

Results All 38 patients were included: 11 received placebo (P group), 27 at least one infusion of rituximab (R group). At 5 years after ABMR, death-censored kidney graft survival was not different (55% in the P group, 57% in the R group). For patients with a functional graft, renal function was not different (eGFR 47 vs 44 mL/min/1.73m[sup2] ; mean proteinuria 0.9 vs 0.3 g/L in the P and R groups respectively). The incidence of bacterial and viral infectious and neoplastic complications was similar.

Conclusion In this cohort, there was no benefit 5 years after ABMR of rituximab in addition with plasma exchanges, IVIg and steroids.

CITATION INFORMATION: Bailly E., Blancho G., Ville S., Morelon E., Bamoulid J., Caillard S., Chatelet V., Malvezzi P., Tourret J., Vuiblet V., Anglicheau D., Bertrand D., Grimbert P., Haidar F., Hazzan M., Kamar N., Merville P., Mousson C., Pernin V., Pouteil-Noble C., Purgus R., Sayegh J., Westeel P., Büchler M. Five-Year Outcomes after Randomized Treatment by Rituximab in Early Acute Antibody-Mediated Rejection in Renal Transplantation: Long Term Outcomes of the RITUX ERAH Study Am J Transplant. 2017;17 (suppl 3).

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