ABO Incompatible Kidney Transplantation Without B-cell Depletion is Associated With Increased Early Acute Rejection: A Single-Center Australian Experience

被引：2
作者：
Bleasel, Jonathan M. [1 ]
Wan, Susan S. [1 ,2 ]
Chadban, Steven J. [1 ,2 ,3 ]
Ying, Tracey [1 ,2 ,3 ]
Gracey, David M. [1 ,3 ]
Aouad, Leyla J. [1 ,2 ,3 ]
Chen, Qian-Ao [3 ]
Utsiwegota, Mike [1 ]
Mawson, Jane [1 ]
Wyburn, Kate R. [1 ,2 ,3 ]
机构：
[1] Royal Prince Alfred Hosp, Dept Renal Med, Sydney, NSW, Australia
[2] Univ Sydney, Charles Perkins Ctr, Kidney Node, Sydney, NSW, Australia
[3] Univ Sydney, Fac Med & Hlth, Cent Clin Sch, Sydney, NSW, Australia
来源：
TRANSPLANT INTERNATIONAL | 2023年 / 36卷
关键词：
ABO incompatible; kidney transplantation; rituximab; immunosuppression; rejection; ANTIGEN-SPECIFIC IMMUNOADSORPTION; RENAL-TRANSPLANTATION; CLINICAL-OUTCOMES; ANTIBODY REMOVAL; RITUXIMAB; SPLENECTOMY; COMPLICATIONS;
D O I：
10.3389/ti.2023.11567
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
We performed a single-center retrospective cohort study of 66 consecutive ABO incompatible kidney transplants (ABOiKT) performed without B-cell depleting therapy. Outcomes were compared to an earlier era performed with rituximab (n = 18) and a contemporaneous cohort of ABO compatible live donor transplants (ABOcKT). Acute rejection within 3 months of transplant was significantly more common after rituximab-free ABOiKT compared to ABOiKT with rituximab (OR 8.8, p = 0.04) and ABOcKT (OR 2.9, p = 0.005) in adjusted analyses. Six recipients of rituximab-free ABOiKT experienced refractory antibody mediated rejection requiring splenectomy, and a further two incurred early graft loss with no such episodes amongst ABOiKT with rituximab or ABOcKT cohorts. Patient and graft survival were similar between groups over a median follow-up of 3.1 years. This observational evidence lends strong support to the continued inclusion of rituximab in desensitization protocols for ABOiKT.
引用
收藏
页数：8
相关论文
共 50 条
  • [21] Outcomes, complications, and economic impact of ABO-incompatible living kidney transplantation: A single-center Japanese cohort study
    Kakuta, Yoichi
    Okumi, Masayoshi
    Unagami, Kohei
    Iizuka, Junpei
    Takagi, Toshio
    Ishida, Hideki
    Tanabe, Kazunari
    CLINICAL TRANSPLANTATION, 2019, 33 (06)
  • [22] Outcomes of ABO-incompatible kidney transplants with very high isoagglutinin titers: a single-center experience and literature review
    Bennani, Hamza Naciri
    Barry, Kadiatou Mamadou Bobo
    Noble, Johan
    Malvezzi, Paolo
    Jouve, Thomas
    Rostaing, Lionel
    FRONTIERS IN IMMUNOLOGY, 2024, 15
  • [23] Long-term outcomes following ABO-incompatible living donor liver transplantation for acute liver failure: a single-center experience of over 20 years
    Kazuya Hirukawa
    Masahiro Shinoda
    Yasushi Hasegawa
    Hideaki Obara
    Minoru Kitago
    Hiroshi Yagi
    Yuta Abe
    Yohei Yamada
    Minoru Tanabe
    Yuko Kitagawa
    Surgery Today, 2023, 53 : 1160 - 1172
  • [24] Long-term outcomes following ABO-incompatible living donor liver transplantation for acute liver failure: a single-center experience of over 20 years
    Hirukawa, Kazuya
    Shinoda, Masahiro
    Hasegawa, Yasushi
    Obara, Hideaki
    Kitago, Minoru
    Yagi, Hiroshi
    Abe, Yuta
    Yamada, Yohei
    Tanabe, Minoru
    Kitagawa, Yuko
    SURGERY TODAY, 2023, 53 (10) : 1160 - 1172
  • [25] Outcome of desensitization in human leukocyte antigen and ABO incompatible living donor kidney transplantation: Single center experience of first 200 incompatible transplants
    Pandey, Prashant
    Setya, Divya
    Sinha, Vijay Kumar
    Devra, Amit K.
    Bhatt, Anil Prasad
    Pande, Amit
    Kumar, Praveen
    Singh, Mukesh Kumar
    Ranjan, Shweta
    JOURNAL OF CLINICAL APHERESIS, 2021, 36 (03) : 299 - 312
  • [26] Dynamic changes of B-cell compartments in kidney transplantation: lack of transitional B cells is associated with allograft rejection
    Svachova, Veronika
    Sekerkova, Alena
    Hruba, Petra
    Tycova, Irena
    Rodova, Marketa
    Cecrdlova, Eva
    Slatinska, Janka
    Honsova, Eva
    Striz, Ilja
    Viklicky, Ondrej
    TRANSPLANT INTERNATIONAL, 2016, 29 (05) : 540 - 548
  • [27] High B-cell activating factor is not associated with worse 3-year graft outcome in blood group-incompatible kidney transplantation with rituximab induction
    Lehnhardt, Anja M.
    Strecker, Maximiliane
    Eiermann, Thomas
    Marget, Matthias
    Thaiss, Friedrich
    Nashan, Bjoern
    Koch, Martina
    CLINICAL TRANSPLANTATION, 2015, 29 (04) : 359 - 364
  • [28] ABO-incompatible Pediatric Liver Transplantation With Antibody and B-cell Depletion-free Immunosuppressive Protoco in High Consanguinity Communities
    Shagrani, Mohammad
    Kumar, Kishwer
    Baker, Alastair
    Al-Awwami, Moheeb
    Alhussaini, Hussa
    Almanea, Hadeel
    Alhumaidan, Hind
    Iorio, Raffaele
    Al-Khabbaz, Hana
    Burdelski, Martin
    Troisi, Roberto, I
    Broering, Dieter C.
    TRANSPLANTATION DIRECT, 2022, 8 (12): : E1353
  • [29] Desensitization With Plasmapheresis and Anti-Cd20 for ABO Incompatible Kidney Transplantation From Living Donor: Experience of a Single Center in Italy
    Silvestre, C.
    Furian, L.
    Marson, P.
    Tison, T.
    Valente, M.
    Marchini, F.
    Rossi, B.
    Bonfante, L.
    Valerio, F.
    Cozzi, E.
    Rigotti, P.
    TRANSPLANTATION PROCEEDINGS, 2014, 46 (07) : 2209 - 2213
  • [30] Willingness to Consider Increased-Risk Donors: A Single-Center Experience in Kidney Transplantation
    Richards, Vanessa L.
    Johnson, Christopher K.
    Perkins, James D.
    Limaye, Ajit P.
    Sibulesky, Lena
    ANNALS OF TRANSPLANTATION, 2018, 23 : 387 - 392
12345