Rituximab is an antibody that binds to the CD20 antigen on B cells resulting in rapid and prolonged depletion. At Northwestern Memorial Hospital, a single dose of rituximab is given to renal transplant recipients with documented historical donor specific antibodies (DSA). There is concern that the administration of rituximab with alemtuzumab induction may lead to increased risk of infectious complications.

Purpose

This study aims to determine if the administration of rituximab for historical DSA in renal transplant recipients who received alemtuzumab induction leads to an increased rate of polyomavirus-BK and cytomegalovirus (CMV) infectious complications.

Methods

Single center, retrospective cohort study of renal transplant recipients who received a single dose of rituximab for historical DSA with alemtuzumab induction. Patients ≥ 18 years old who were transplanted between January 1^st 2007 and October 31^st 2016 were included. These patients were matched 1:1 based on donor/recipient CMV serostatus with patients who did not receive rituximab. Incidence of polyomavirus-BK viruria, viremia, nephropathy and CMV viremia within one year post-transplant were evaluated.

Results

A total of 326 patients (163 patients in each group) were included in the study. Patient demographics are summarized in Table 1. Incidence of polyomavirus-BK viruria (p<0.01), viremia (p<0.01) and nephropathy (p=0.05) were significantly greater in the rituximab group compared to the control group (Figure 1). There was no difference in CMV viremia between the rituximab and control (p=0.31).

Conclusions

Rituximab administration for historical DSA in renal transplant recipients also receiving alemtuzumab induction was associated with higher rates of polyomavirus-BK infectious complications within one year post-transplant.

CITATION INFORMATION: Kraljevic A., D'Agostino C., Kane C., Cunningham K., Shetty A., Richardson C. The Incidence of Polyomavirus-BK and Cytomegalovirus Infections in Renal Transplant Recipients Following Rituximab Administration Am J Transplant. 2017;17 (suppl 3).

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