論文

国際誌
2020年12月

Low-dose rituximab induction therapy is effective in immunological high-risk renal transplantation without increasing cytomegalovirus infection.

International journal of urology : official journal of the Japanese Urological Association
  • Kasumi Yoshinaga
  • Motoo Araki
  • Koichiro Wada
  • Yuki Maruyama
  • Yosuke Mitsui
  • Takuya Sadahira
  • Risa Kubota
  • Shingo Nishimura
  • Yasuyuki Kobayashi
  • Hidemi Takeuchi
  • Katsuyuki Tanabe
  • Masashi Kitagawa
  • Hiroshi Morinaga
  • Haruhito Adam Uchida
  • Shinji Kitamura
  • Hitoshi Sugiyama
  • Jun Wada
  • Masami Watanabe
  • Toyohiko Watanabe
  • Yasutomo Nasu
  • 全て表示

27
12
開始ページ
1136
終了ページ
1142
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1111/iju.14382

OBJECTIVES: To analyze the effect and impact of low-dose rituximab induction therapy on cytomegalovirus infection in living-donor renal transplantation. METHODS: A total of 92 recipients undergoing living-donor renal transplantation at Okayama University Hospital from May 2009 to August 2018 were evaluated retrospectively. Indications for preoperative rituximab (200 mg/body) were the following: (i) ABO major mismatch; (ii) ABO minor mismatch; (iii) donor-specific anti-human leukocyte antigen antibody-positive; and (iv) focal segmental glomerulosclerosis. We excluded four recipients who were followed <3 months, five who received >200 mg/body rituximab and seven who received prophylactic therapy for cytomegalovirus. RESULTS: There were 59 patients in the rituximab group and 17 in the non-rituximab group. Groups differed significantly in age (median age 53 vs 37 years, respectively; P = 0.04), but not in sex (male 64% vs 65%, P = 1.00), focal segmental glomerulosclerosis (3% vs 0%, P = 1.00) or percentage of cytomegalovirus-seronegative recipients of renal allografts from cytomegalovirus-seropositive donors (12% vs 18%, P = 0.68). The estimated glomerular filtration rate did not differ significantly between groups until 24 months after transplantation. Cytomegalovirus clinical symptoms (10% vs 24%, P = 0.22), including fever ≥38°C (5% vs 12%, P = 0.31) and gastrointestinal symptoms (5% vs 12%, P = 0.31), and the 5-year survival rates of death-censored graft loss (90% vs 83%, P = 0.43) did not differ significantly between groups. CONCLUSIONS: Low-dose rituximab induction therapy is effective in immunological high-risk recipients without increasing cytomegalovirus infection in the absence of valganciclovir prophylaxis.

リンク情報
DOI
https://doi.org/10.1111/iju.14382
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33012030
ID情報
  • DOI : 10.1111/iju.14382
  • PubMed ID : 33012030

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