MP31-17 LOW-DOSE RITUXIMAB INDUCTION THERAPY IN IMMUNOLOGIC HIGH-RISK RENAL TRANSPLANTATION PROVIDES FAVORABLE GRAFT OUTCOMES WITHOUT INCREASING CYTOMEGALOVIRUS INFECTION: A 5-YEAR FOLLOW-UP

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP31-17 LOW-DOSE RITUXIMAB INDUCTION THERAPY IN IMMUNOLOGIC HIGH-RISK RENAL TRANSPLANTATION PROVIDES FAVORABLE GRAFT OUTCOMES WITHOUT INCREASING CYTOMEGALOVIRUS INFECTION: A 5-YEAR FOLLOW-UP Kasumi Yoshinaga, Yuki Maruyama, Tomoaki Yamanoi, Shingo Nishimura, Yusuke Tominaga, Satoshi Katayama, Takehiro Iwata, Kohei Edamura, Tomoko Kobayashi, Yasuyuki Kobayashi, Toyohiko Watanabe, and Motoo Araki Kasumi YoshinagaKasumi Yoshinaga More articles by this author , Yuki MaruyamaYuki Maruyama More articles by this author , Tomoaki YamanoiTomoaki Yamanoi More articles by this author , Shingo NishimuraShingo Nishimura More articles by this author , Yusuke TominagaYusuke Tominaga More articles by this author , Satoshi KatayamaSatoshi Katayama More articles by this author , Takehiro IwataTakehiro Iwata More articles by this author , Kohei EdamuraKohei Edamura More articles by this author , Tomoko KobayashiTomoko Kobayashi More articles by this author , Yasuyuki KobayashiYasuyuki Kobayashi More articles by this author , Toyohiko WatanabeToyohiko Watanabe More articles by this author , and Motoo ArakiMotoo Araki More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003264.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We previously reported that low-dose rituximab induction therapy in immunologic high-risk patients for living donor renal transplantation did not increase CMV infections when preemptive therapy was performed. We now report additional long-term outcomes. METHODS: One-hundred thirty-one recipients undergoing living-donor renal transplantation in our institution from May 2009 to September 2021 were evaluated retrospectively. Indications for preoperative rituximab (200 mg/body) were the following: 1. ABO major mismatch, 2. ABO minor mismatch, 3. donor-specific anti-human leukocyte antigen antibody (DSA)-positive, 4. Focal segmental glomerulosclerosis (FSGS). RESULTS: There were 83 patients in the rituximab group and 34 in the non-rituximab group. Groups differed significantly in age (median age, 51 vs 42 years, respectively; P=0.03), but not in sex (male, 66% vs 68% P=1.00), FSGS (4% vs 0%, P=0.56). Estimated glomerular filtration rate did not differ significantly between groups until 5 years after transplantation (Figure 1). CMV clinical symptoms (14% vs 26%, P=0.18), including fever over 38 degrees (8% vs 12%, P=0.73) and gastrointestinal symptoms (7% vs 12%, P=0.06), and the 5-year survival rates of death-censored graft loss (95% vs 96%, P=0.52) did not differ significantly between two groups (Figure 2). CONCLUSIONS: As in our previous study, low-dose rituximab induction therapy was effective in immunologically high-risk recipients without increasing CMV infection without valganciclovir prophylaxis. Furthermore, the graft survival rate and renal function at 5 years after transplantation were equivalent to those in the non-rituximab group. Source of Funding: No © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e436 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kasumi Yoshinaga More articles by this author Yuki Maruyama More articles by this author Tomoaki Yamanoi More articles by this author Shingo Nishimura More articles by this author Yusuke Tominaga More articles by this author Satoshi Katayama More articles by this author Takehiro Iwata More articles by this author Kohei Edamura More articles by this author Tomoko Kobayashi More articles by this author Yasuyuki Kobayashi More articles by this author Toyohiko Watanabe More articles by this author Motoo Araki More articles by this author Expand All Advertisement PDF downloadLoading ...