Neither pre-transplant rituximab nor splenectomy affects de novo HLA antibody production after renal transplantation
The long-term effect of rituximab and splenectomy on de novo HLA antibody production and chronic antibody-mediated rejection after renal transplantation is uncertain. In order to gain insight on this, we studied 92 ABO-incompatible and 228 ABO-identical/compatible consecutive renal transplant patien...
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| Veröffentlicht in: | Kidney international 2014-02, Vol.85 (2), p.425-430 |
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| creator | Ashimine, Satoshi Watarai, Yoshihiko Yamamoto, Takayuki Hiramitsu, Takahisa Tsujita, Makoto Nanmoku, Koji Goto, Norihiko Takeda, Asami Katayama, Akio Uchida, Kazuharu Kobayashi, Takaaki |
| description | The long-term effect of rituximab and splenectomy on de novo HLA antibody production and chronic antibody-mediated rejection after renal transplantation is uncertain. In order to gain insight on this, we studied 92 ABO-incompatible and 228 ABO-identical/compatible consecutive renal transplant patients and determined their de novo HLA antibody production and graft outcome. Patients with pretransplant donor-specific antibodies had been excluded. ABO-incompatible transplants included 30 recipients treated with rituximab, 51 by splenectomy, or 11 with neither, due to low anti-A or -B antibody titer. Graft survival in ABO-identical/compatible patients (97.7% at 5 years) was significantly higher than in ABO-incompatible (87.0% at 5 years), rituximab (96.7% at 3 years), or splenectomy (85.7% at 5 years) patients. Only four patients had clinical chronic antibody-mediated rejection (two each identical/compatible and incompatible). There was no significant difference in prevalence of de novo HLA antibody, including donor-specific and nondonor-specific antibodies among ABO-identical/compatible patients (13.9%), patients receiving rituximab (14.3%) or splenectomy (13.2%), or among those receiving cyclosporine, tacrolimus, mycophenolate mofetil, mizoribine, and everolimus. Renal function remained stable in most recipients with de novo HLA antibody. Thus, neither pretransplant splenectomy nor rituximab treatment has an inhibitory effect on de novo HLA antibody production during medium-term follow-up. Further study on long-term effects is needed. |
| doi_str_mv | 10.1038/ki.2013.291 |
| format | Article |
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In order to gain insight on this, we studied 92 ABO-incompatible and 228 ABO-identical/compatible consecutive renal transplant patients and determined their de novo HLA antibody production and graft outcome. Patients with pretransplant donor-specific antibodies had been excluded. ABO-incompatible transplants included 30 recipients treated with rituximab, 51 by splenectomy, or 11 with neither, due to low anti-A or -B antibody titer. Graft survival in ABO-identical/compatible patients (97.7% at 5 years) was significantly higher than in ABO-incompatible (87.0% at 5 years), rituximab (96.7% at 3 years), or splenectomy (85.7% at 5 years) patients. Only four patients had clinical chronic antibody-mediated rejection (two each identical/compatible and incompatible). There was no significant difference in prevalence of de novo HLA antibody, including donor-specific and nondonor-specific antibodies among ABO-identical/compatible patients (13.9%), patients receiving rituximab (14.3%) or splenectomy (13.2%), or among those receiving cyclosporine, tacrolimus, mycophenolate mofetil, mizoribine, and everolimus. Renal function remained stable in most recipients with de novo HLA antibody. Thus, neither pretransplant splenectomy nor rituximab treatment has an inhibitory effect on de novo HLA antibody production during medium-term follow-up. Further study on long-term effects is needed.</description><identifier>ISSN: 0085-2538</identifier><identifier>EISSN: 1523-1755</identifier><identifier>DOI: 10.1038/ki.2013.291</identifier><identifier>PMID: 23945498</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>ABO Blood-Group System - immunology ; Adolescent ; Adult ; Aged ; Antibodies, Monoclonal, Murine-Derived - administration & dosage ; Biomarkers - blood ; Blood Group Incompatibility - immunology ; Child ; Child, Preschool ; desensitization ; Drug Administration Schedule ; Female ; Graft Rejection - immunology ; Graft Rejection - prevention & control ; Graft Survival - drug effects ; Histocompatibility ; HLA antibodies ; HLA Antigens - immunology ; Humans ; Immunosuppressive Agents - administration & dosage ; Isoantibodies - blood ; Kidney Transplantation - adverse effects ; Male ; Middle Aged ; Preoperative Care ; renal transplantation ; Retrospective Studies ; Rituximab ; Splenectomy ; Time Factors ; Treatment Outcome ; Young Adult</subject><ispartof>Kidney international, 2014-02, Vol.85 (2), p.425-430</ispartof><rights>2014 International Society of Nephrology</rights><rights>Copyright Nature Publishing Group Feb 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c466t-ed714a8c2f1920b48e5336c3a4cf7a8597ed991643938e396585de8be9346c2e3</citedby><cites>FETCH-LOGICAL-c466t-ed714a8c2f1920b48e5336c3a4cf7a8597ed991643938e396585de8be9346c2e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1492957556?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23945498$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ashimine, Satoshi</creatorcontrib><creatorcontrib>Watarai, Yoshihiko</creatorcontrib><creatorcontrib>Yamamoto, Takayuki</creatorcontrib><creatorcontrib>Hiramitsu, Takahisa</creatorcontrib><creatorcontrib>Tsujita, Makoto</creatorcontrib><creatorcontrib>Nanmoku, Koji</creatorcontrib><creatorcontrib>Goto, Norihiko</creatorcontrib><creatorcontrib>Takeda, Asami</creatorcontrib><creatorcontrib>Katayama, Akio</creatorcontrib><creatorcontrib>Uchida, Kazuharu</creatorcontrib><creatorcontrib>Kobayashi, Takaaki</creatorcontrib><title>Neither pre-transplant rituximab nor splenectomy affects de novo HLA antibody production after renal transplantation</title><title>Kidney international</title><addtitle>Kidney Int</addtitle><description>The long-term effect of rituximab and splenectomy on de novo HLA antibody production and chronic antibody-mediated rejection after renal transplantation is uncertain. In order to gain insight on this, we studied 92 ABO-incompatible and 228 ABO-identical/compatible consecutive renal transplant patients and determined their de novo HLA antibody production and graft outcome. Patients with pretransplant donor-specific antibodies had been excluded. ABO-incompatible transplants included 30 recipients treated with rituximab, 51 by splenectomy, or 11 with neither, due to low anti-A or -B antibody titer. Graft survival in ABO-identical/compatible patients (97.7% at 5 years) was significantly higher than in ABO-incompatible (87.0% at 5 years), rituximab (96.7% at 3 years), or splenectomy (85.7% at 5 years) patients. Only four patients had clinical chronic antibody-mediated rejection (two each identical/compatible and incompatible). There was no significant difference in prevalence of de novo HLA antibody, including donor-specific and nondonor-specific antibodies among ABO-identical/compatible patients (13.9%), patients receiving rituximab (14.3%) or splenectomy (13.2%), or among those receiving cyclosporine, tacrolimus, mycophenolate mofetil, mizoribine, and everolimus. Renal function remained stable in most recipients with de novo HLA antibody. Thus, neither pretransplant splenectomy nor rituximab treatment has an inhibitory effect on de novo HLA antibody production during medium-term follow-up. Further study on long-term effects is needed.</description><subject>ABO Blood-Group System - immunology</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Antibodies, Monoclonal, Murine-Derived - administration & dosage</subject><subject>Biomarkers - blood</subject><subject>Blood Group Incompatibility - immunology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>desensitization</subject><subject>Drug Administration Schedule</subject><subject>Female</subject><subject>Graft Rejection - immunology</subject><subject>Graft Rejection - prevention & control</subject><subject>Graft Survival - drug effects</subject><subject>Histocompatibility</subject><subject>HLA antibodies</subject><subject>HLA Antigens - immunology</subject><subject>Humans</subject><subject>Immunosuppressive Agents - administration & dosage</subject><subject>Isoantibodies - blood</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Preoperative Care</subject><subject>renal transplantation</subject><subject>Retrospective Studies</subject><subject>Rituximab</subject><subject>Splenectomy</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0085-2538</issn><issn>1523-1755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNptkc1rVDEUxYModqyu3EvAjSBvms83ybIU2wqD3dR1yEvuw7QzL2OSVzr_vXc6VUFcJbn3l8PhHELec7bkTJqz-7QUjMulsPwFWXAtZMdXWr8kC8aM7oSW5oS8qfWO4dtK9pqcCGmVVtYsSPsGqf2AQncFulb8VHcbPzVaUpsf09YPdMqF4hAmCC1v99SPI94qjYCrh0yv1-cUf6Qhxz2q5DiHlvKEXEPZApPf0L_C_rB7S16NflPh3fN5Sr5ffrm9uO7WN1dfL87XXVB93zqIK668CWLkVrBBGdBS9kF6FcaVN9quIFrLeyWtNCBtr42OYAawUvVBgDwln466aOvnDLW5baoBNmgE8lwdV1ZJprjiiH78B73Lc0HvT5SwGhPtkfp8pELJtRYY3a5gSGXvOHOHMtx9cocyHJaB9IdnzXnYQvzD_k4fAX0EAEN4SFBcDQmmADEVzNjFnP4r_AuCEpfY</recordid><startdate>20140201</startdate><enddate>20140201</enddate><creator>Ashimine, Satoshi</creator><creator>Watarai, Yoshihiko</creator><creator>Yamamoto, Takayuki</creator><creator>Hiramitsu, Takahisa</creator><creator>Tsujita, Makoto</creator><creator>Nanmoku, Koji</creator><creator>Goto, Norihiko</creator><creator>Takeda, Asami</creator><creator>Katayama, Akio</creator><creator>Uchida, Kazuharu</creator><creator>Kobayashi, Takaaki</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20140201</creationdate><title>Neither pre-transplant rituximab nor splenectomy affects de novo HLA antibody production after renal transplantation</title><author>Ashimine, Satoshi ; Watarai, Yoshihiko ; Yamamoto, Takayuki ; Hiramitsu, Takahisa ; Tsujita, Makoto ; Nanmoku, Koji ; Goto, Norihiko ; Takeda, Asami ; Katayama, Akio ; Uchida, Kazuharu ; Kobayashi, Takaaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c466t-ed714a8c2f1920b48e5336c3a4cf7a8597ed991643938e396585de8be9346c2e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>ABO Blood-Group System - immunology</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Antibodies, Monoclonal, Murine-Derived - administration & dosage</topic><topic>Biomarkers - blood</topic><topic>Blood Group Incompatibility - immunology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>desensitization</topic><topic>Drug Administration Schedule</topic><topic>Female</topic><topic>Graft Rejection - immunology</topic><topic>Graft Rejection - prevention & control</topic><topic>Graft Survival - drug effects</topic><topic>Histocompatibility</topic><topic>HLA antibodies</topic><topic>HLA Antigens - immunology</topic><topic>Humans</topic><topic>Immunosuppressive Agents - administration & dosage</topic><topic>Isoantibodies - blood</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Preoperative Care</topic><topic>renal transplantation</topic><topic>Retrospective Studies</topic><topic>Rituximab</topic><topic>Splenectomy</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ashimine, Satoshi</creatorcontrib><creatorcontrib>Watarai, Yoshihiko</creatorcontrib><creatorcontrib>Yamamoto, Takayuki</creatorcontrib><creatorcontrib>Hiramitsu, Takahisa</creatorcontrib><creatorcontrib>Tsujita, Makoto</creatorcontrib><creatorcontrib>Nanmoku, Koji</creatorcontrib><creatorcontrib>Goto, Norihiko</creatorcontrib><creatorcontrib>Takeda, Asami</creatorcontrib><creatorcontrib>Katayama, Akio</creatorcontrib><creatorcontrib>Uchida, Kazuharu</creatorcontrib><creatorcontrib>Kobayashi, Takaaki</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Kidney international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ashimine, Satoshi</au><au>Watarai, Yoshihiko</au><au>Yamamoto, Takayuki</au><au>Hiramitsu, Takahisa</au><au>Tsujita, Makoto</au><au>Nanmoku, Koji</au><au>Goto, Norihiko</au><au>Takeda, Asami</au><au>Katayama, Akio</au><au>Uchida, Kazuharu</au><au>Kobayashi, Takaaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neither pre-transplant rituximab nor splenectomy affects de novo HLA antibody production after renal transplantation</atitle><jtitle>Kidney international</jtitle><addtitle>Kidney Int</addtitle><date>2014-02-01</date><risdate>2014</risdate><volume>85</volume><issue>2</issue><spage>425</spage><epage>430</epage><pages>425-430</pages><issn>0085-2538</issn><eissn>1523-1755</eissn><abstract>The long-term effect of rituximab and splenectomy on de novo HLA antibody production and chronic antibody-mediated rejection after renal transplantation is uncertain. In order to gain insight on this, we studied 92 ABO-incompatible and 228 ABO-identical/compatible consecutive renal transplant patients and determined their de novo HLA antibody production and graft outcome. Patients with pretransplant donor-specific antibodies had been excluded. ABO-incompatible transplants included 30 recipients treated with rituximab, 51 by splenectomy, or 11 with neither, due to low anti-A or -B antibody titer. Graft survival in ABO-identical/compatible patients (97.7% at 5 years) was significantly higher than in ABO-incompatible (87.0% at 5 years), rituximab (96.7% at 3 years), or splenectomy (85.7% at 5 years) patients. Only four patients had clinical chronic antibody-mediated rejection (two each identical/compatible and incompatible). There was no significant difference in prevalence of de novo HLA antibody, including donor-specific and nondonor-specific antibodies among ABO-identical/compatible patients (13.9%), patients receiving rituximab (14.3%) or splenectomy (13.2%), or among those receiving cyclosporine, tacrolimus, mycophenolate mofetil, mizoribine, and everolimus. Renal function remained stable in most recipients with de novo HLA antibody. Thus, neither pretransplant splenectomy nor rituximab treatment has an inhibitory effect on de novo HLA antibody production during medium-term follow-up. Further study on long-term effects is needed.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23945498</pmid><doi>10.1038/ki.2013.291</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | ABO Blood-Group System - immunology Adolescent Adult Aged Antibodies, Monoclonal, Murine-Derived - administration & dosage Biomarkers - blood Blood Group Incompatibility - immunology Child Child, Preschool desensitization Drug Administration Schedule Female Graft Rejection - immunology Graft Rejection - prevention & control Graft Survival - drug effects Histocompatibility HLA antibodies HLA Antigens - immunology Humans Immunosuppressive Agents - administration & dosage Isoantibodies - blood Kidney Transplantation - adverse effects Male Middle Aged Preoperative Care renal transplantation Retrospective Studies Rituximab Splenectomy Time Factors Treatment Outcome Young Adult |
| title | Neither pre-transplant rituximab nor splenectomy affects de novo HLA antibody production after renal transplantation |
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