Open AccessInfluence of preoperative anti‐ HLA antibodies on short‐ and long‐term graft survival in recipients with or without rituximab treatment
Author(s) -
Ishida Hideki,
Furusawa Miyuki,
Shimizu Tomokazu,
Nozaki Taiji,
Tanabe Kazunari
Publication year - 2014
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12267
Subject(s) - medicine , rituximab , antibody , survival rate , gastroenterology , surgery , transplantation , urology , immunology
Summary We investigated the relationship between preoperative anti‐ HLA antibodies (donor‐specific antibody, DSA ) and the graft survival rate in recipients who had or had not received rituximab (Rit) treatment. The subjects were categorized into four groups as follows: DSA +Rit−, n = 39; DSA −Rit−, n = 121; DSA +Rit+, n = 74; and DSA −Rit+, n = 47. We examined the influence of preoperative DSA on the incidence of graft rejection and the survival rate of recipients who had or who had not received rituximab before transplantation. The 6‐month acute rejection rates based on graft biopsies were 39%, 19%, 15%, and 0% for the DSA +Rit−, DSA −Rit−, DSA +Rit+, and DSA −Rit+ groups. The rates of chronic antibody‐mediated rejection after more than 6 months were 50%, 22%, 18%, and 0%. The 5‐year graft survival rate was significantly lower in the DSA +Rit− group (84%) than in the other groups (95% for DSA −Rit−, 98% for DSA +Rit+, and 91% for DSA −Rit+). The rate of the appearance of de novo anti‐ HLA antibodies was higher in the groups that did not receive rituximab treatment. The rate of graft loss associated with chronic antibody‐mediated rejection was also higher in the DSA +Rit− group than in the other groups ( P = 0.01). The presence of DSA and the administration of rituximab had strong impacts on not only short‐term graft rejection, but also long‐term graft rejection and its association with the graft survival time.