Kidney Week

Abstract: SA-PO024

Outcomes in Sensitized Kidney Transplant Recipients Treated with Rituximab

Session Information

• Transplantation: Clinical Outcomes
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Lamba, Perola, New York Presbyterian/Weill Cornell Medicine, New York, New York, United States

Perola Lamba,

• Lamba, Isha, Weill Cornell Medicine-Qatar, Doha, Qatar

Isha Lamba,

• Friedlander, Rex, The Rogosin Institute, New York, New York, United States

Rex Friedlander,

• Lubetzky, Michelle L., Weill Cornell Medicine, New York, New York, United States

Michelle L. Lubetzky,

• Lee, John Richard, Weill Cornell Medicine, New York, New York, United States

John Richard Lee,

• Lee, Jun B., The Rogosin Institute, New York, New York, United States

Jun B. Lee,

• Hartono, Choli, The Rogosin Institute, New York, New York, United States

Choli Hartono,

• Serur, David, The Rogosin Institute, New York, New York, United States

David Serur,

• Muthukumar, Thangamani, Weill Cornell Medicine, New York, New York, United States

Thangamani Muthukumar,

• Sharma, Vijay K., The Rogosin Institute, New York, New York, United States

Vijay K. Sharma,

• Dadhania, Darshana, Weill Cornell Medicine, New York, New York, United States

Darshana Dadhania,

Group or Team Name

• Weill Cornell Medicine

Background

Donor specific antibodies (DSAs) are associated with increased risk of rejection & graft loss following kidney transplantation (KT). Patients with DSA & positive flow cytometry crossmatch (XM) were treated with rituximab at transplant while those with negative XM and DSA were not. We evaluated clinical outcomes of patients with DSA at time of transplant stratified by rituximab therapy.

Methods

Retrospective review of sensitized KT recipients with DSA were studied excluding ABO-incompatible transplants. Graft survival was compared using log-rank test & multivariable analysis was performed using logistic regression.

Results

Individuals treated with rituximab were more likely to receive steroid maintenance & had higher DSA MFI-Sum (Table 1). One-year acute rejection rates were not different between those treated with & without rituximab. The survival of rituximab treated group was significantly lower (Fig. 1, P=0.02). In a logistic regression model, none of the variables were independent predictors of graft survival, rituximab therapy (P=0.24), steroid therapy (P=0.83), MFI-Sum category (P=0.44).

Conclusion

Among sensitized patients, those treated with rituximab had higher levels of DSA and had decreased overall graft survival. Treatment with rituximab was not independently associated with increased risk of graft loss. Additional studies are need to truly evaluate the risks & benefits of rituximab therapy in the highly sensitized patient population.