Korean J Transplant.  2021 Oct;35(Supple 1):S98. 10.4285/ATW2021.OP-1168.

The optimal dosage of rituximab for ABO-incompatible kidney transplantation: comparative analysis of efficacy and safety

• Kwon HE
• Kim YH
• Shin S
• Jung JH
• Kwon H

• KMID: 2521378
• DOI: http://doi.org/10.4285/ATW2021.OP-1168

Abstract

Background
Rituximab is an essential induction drug for ABO-incompatible (ABOi) kidney transplantation (KT). However, the optimal dosage of rituximab in ABOi KT remains unclear. Therefore, we evaluated the efficacy and safety of 100 mg/body rituximab compared to 200 mg/body rituximab protocol in ABOi KT.
Methods
A total of 196 patients who received ABOi KT in the period from July 2017 to December 2019 at Asan Medical Center were divided into rituximab 100 group (n=122, 61.6%) and rituximab 200 group (n=76, 38.4%).
Results
The overall graft survival showed no significant differences in both groups (P=0.37). The 3-year graft survival rate for rituximab 100 and rituximab 200 were 96.5% and 96.6%, respectively. The rejection-free graft survival rates (RFGS) were also similar in both groups (P=0.67). The 3-year RFGS for rituximab 100 and rituximab 200 were 87.3% and 89.0%, respectively. The incidence of de novo donor-specific antibody showed no significant difference between two groups (rituximab 100 vs. 200; n=8, 6.6% vs. n=9, 11.8%) (P=0.20). Infectious complications, including cytomegalovirus, BK virus, urinary tract infection, and pneumonia also showed no differences in both groups.
Conclusions
Our study demonstrated that 100 mg/body rituximab protocol in ABOi KT afforded comparable graft survival and RFGS. These findings suggest that low-dose rituximab (100 mg) is a treatment option that provides successful desensitization for ABOi KT.