Pharmacodynamics of rituximab in kidney transplantation

Transplantation. 2007 Dec 27;84(12 Suppl):S33-6. doi: 10.1097/


The B-cell depleting anti-CD20 antibody rituximab has become a therapeutic alternative in renal transplantation. However, understanding of the pharmacodynamics is limited. We have therefore studied the effect of single-dose rituximab, in combination with conventional triple immunosuppressive therapy, on the B-cell population in peripheral blood as well as in tissues, in kidney transplant recipients. Forty-nine kidney recipients received single-dose rituximab. The prevalence of B cells was assessed in peripheral blood, kidney transplant tissue, and in lymph nodes. In 88%, complete depletion of B cells in peripheral blood was observed and, 15 months after treatment, B cells were still undetectable in the majority of patients. In kidney tissue, B cells were also completely eliminated. In contrast, the B cells were not eliminated in lymph nodes, although a reduction was observed. In conclusion, single-dose rituximab in kidney transplant recipients evokes a long-term elimination of B-cells in peripheral blood as well as within the kidney transplant.

MeSH terms

  • Adult
  • Antibodies, Monoclonal / pharmacology*
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD19 / biosynthesis
  • Antigens, CD20 / biosynthesis
  • B-Lymphocytes / metabolism
  • Child
  • Flow Cytometry / methods
  • Humans
  • Immunohistochemistry / methods*
  • Immunosuppressive Agents / pharmacology*
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / methods*
  • Lymph Nodes / pathology
  • Models, Biological
  • Rituximab
  • Transplantation Immunology
  • Treatment Outcome


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD19
  • Antigens, CD20
  • Immunosuppressive Agents
  • Rituximab