2013 - IXA 2013 Congress
Plenary 1: iABO Immune Solid Organ Transplantation
5.6 - iABO KT in Japan
Presenter: Naoki, Kawagishi, , Japan
Impact of rituximab desensitization on blood-type-incompatible living donor liver transplantation in adults: A Japanese multicenter study
N. Kawagishia, S. Teramukaib, H. Egawac
aDepartment of Surgery, Graduate School of Medicine, Tohoku University, Miyagi, Japan
bInnovative Clinical Research Center, Kanazawa University, Kanazawa, Japan
cDepartment of Surgery, Institute of Gastroenterology, Tokyo Women’s Medical University, Tokyo, Japan
We evaluated the effects of rituximab prophylaxis on outcomes of ABO-blood-type-incompatible living donor liver transplantation (ABO-I LDLT) in 381 adult patients in the Japanese registry of ABO-I LDLT. All patients underwent triple immunosuppression together with plasmapheresis or splenectomy or both; regimens were classified into 3 groups according to additional treatment: none (Base group, n = 25); local infusion therapy (Infusion group, n = 94); and rituximab prophylaxis (Rituximab group, n = 258). The incidence of antibody-mediated rejection (AMR) was significantly lower in the Rituximab group (6%) than in the Base (28%) or Infusion (22%) group (P < 0.001), and 5-year survival was significantly higher in the Rituximab group (71%) than in the other groups (33%, 51%, respectively; P < 0.001). Among preoperative and short-term postoperative variables, only rituximab prophylaxis was significantly associated with survival time and MELD score. Intraoperative titer of IgG anti-donor antibodies and rituximab prophylaxis were significant predictors of AMR incidence. In the Rituximab group, other B-cell desensitization therapies had no add-on effects. Multiple or large rituximab doses significantly increased infection, and early administration had no advantage. In conclusion, a single moderate dose of rituximab was safe and effective in adult ABO-I LDLT.
You must be logged in to view recordings
By viewing the material on this site you understand and accept that:
- The opinions and statements expressed on this site reflect the views of the author or authors and do not necessarily reflect those of The Transplantation Society and/or its Sections.
- The hosting of material on The Transplantation Society site does not signify endorsement of this material by The Transplantation Society and/or its Sections.
- The material is solely for educational purposes for qualified health care professionals.
- The Transplantation Society and/or its Sections are not liable for any decision made or action taken based on the information contained in the material on this site.
- The information cannot be used as a substitute for professional care.
- The information does not represent a standard of care.
- No physician-patient relationship is being established.