Acute Cellular Rejection in ABO-Incompatible Renal Transplant Recipients Receiving Rituximab Is Associated with Delayed-Onset Neutropenia.

Abstract

BACKGROUND Rituximab induces long-lasting B cell depletion in the peripheral blood and increases the levels of proinflammatory cytokines associated with regulatory B cell depletion. Previous reports showed that B cell-related cytokine release after administration of rituximab may induce acute cellular rejection (ACR) and delayed-onset neutropenia. The present study was conducted to investigate the correlation between acute rejection and delayed-onset neutropenia in ABO-incompatible renal transplant recipients who underwent administration of rituximab for 1 year after transplantation. MATERIAL AND METHODS From June 2006 to July 2015, 47 patients with chronic renal failure received ABO-incompatible renal transplant with rituximab induction at Osaka City University Hospital. All 47 patients underwent plasmapheresis due to removal of anti-A/B antibodies and administration of rituximab, and their transplants were carried out successfully. We investigated the correlation between ACR and delayed-onset neutropenia in ABO-incompatible renal transplant recipients who underwent administration of rituximab for 1 year after transplantation. RESULTS Fourteen patients (29.8%) experienced ACR (group A), and 33 recipients did not develop ACR (group B). The frequency of delayed-onset neutropenia was higher in group A than in group B (p=0.0503). Multivariate logistic regression analysis revealed that the frequency of ACR correlated significantly with the prevalence of delayed-onset neutropenia. CONCLUSIONS Our results indicated that ACR in ABO-incompatible renal transplant recipients receiving rituximab was associated with delayed-onset neutropenia.

• Authors: Junji Uchida, Tomoaki Iwai, Shunji Nishide, Kazuya Kabei, Nobuyuki Kuwabara, Takeshi Yamasaki, Toshihide Naganuma, Norihiko Kumada, Yoshiaki Takemoto, Tatsuya Nakatani
• Journal: Annals of transplantation (Ann Transplant) Vol. 22 Pg. 455-462 (Jul 25 2017) ISSN: 2329-0358 [Electronic] United States
• PMID: 28740069 (Publication Type: Journal Article)

Chemical References

• ABO Blood-Group System
• Immunosuppressive Agents
• Rituximab

Topics

• ABO Blood-Group System (immunology)
• Adolescent
• Adult
• Aged
• Blood Group Incompatibility (complications, immunology)
• Female
• Graft Rejection (complications, immunology)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Kidney Failure, Chronic (surgery)
• Kidney Transplantation
• Male
• Middle Aged
• Neutropenia (complications, immunology)
• Plasmapheresis
• Rituximab (therapeutic use)
• Treatment Outcome
• Young Adult