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The impact of rituximab in ABO ‐incompatible pediatric living donor liver transplantation: The experience of a single center
Author(s) -
Okada Noriki,
Sanada Yukihiro,
Hirata Yuta,
Yamada Naoya,
Wakiya Taiichi,
Ihara Yoshiyuki,
Urahashi Taizen,
Miki Atsushi,
Kaneda Yuji,
Sasanuma Hideki,
Fujiwara Takehito,
Sakuma Yasunaru,
Shimizu Atsushi,
Hyodo Masanobu,
Yasuda Yoshikazu,
Mizuta Koichi
Publication year - 2015
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12445
Subject(s) - medicine , rituximab , plasmapheresis , abo blood group system , single center , surgery , gastroenterology , pediatrics , antibody , immunology , lymphoma
Previous studies have demonstrated the safety of ABO ‐incompatible pediatric LDLT using preoperative plasmapheresis and rituximab; however, no reports have described the timing and dosage of rituximab administration for pediatric LDLT . This study aimed to describe a safe and effective dosage and timing of rituximab for patients undergoing pediatric ABO ‐incompatible LDLT based on the experience of our single center. A total of 192 LDLT s in 187 patients were examined. These cases included 29 ABO ‐incompatible LDLT s in 28 patients. Rituximab was used beginning in January 2004 in recipients older than two yr of age (first period: 375 mg/m 2 in two cases; second period: 50 mg/m 2 in two cases; and 200 mg/m 2 in eight cases). Two patients who received 375 mg/m 2 rituximab died of Pneumocystis carinii pneumonia and hemophagocytic syndrome. One patient who received 50 mg/m 2 rituximab required retransplantation as a consequence of antibody‐mediated complications. All eight patients administered 200 mg/m 2 survived, and the mean CD 20 + lymphocyte count was 0.1% at the time of LDLT . In the preoperative management of patients undergoing pediatric ABO ‐incompatible LDLT , the administration of 200 mg/m 2 rituximab three wk prior to LDLT was safe and effective.