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.
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页数：8
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