Impact of low-dose rituximab on splenic B cells in ABO-incompatible renal transplant recipients

Transpl Int. 2009 Apr;22(4):447-54. doi: 10.1111/j.1432-2277.2008.00821.x. Epub 2008 Dec 23.


The purpose of this study was to assess the effect of a low-dose rituximab (RIT) at < 375 mg/m(2) on B cells in the spleen and peripheral blood. Five renal transplant recipients received a single dose of RIT at 10, 15, 35, 150, or 300 mg/m(2) 3-13 days before transplantation. One patient who received the same immunosuppressive regimen except for RIT was also enrolled as a control. Splenectomy was performed at the time of transplantation in all patients. The B-cell count in the peripheral blood was analysed with a fluorescence-activated cell sorter using anti-CD19 antibodies, and the B cells in the spleen were analysed by immunohistochemistry using anti-CD20 and -CD79a antibodies. All but one dosage (10 mg/m(2)) of RIT completely eliminated B cells from the circulation within 30 days. Immunohistochemical examination of the spleen showed a marked reduction of B cells in the white pulps in all five recipients compared with that in the control patient. The observations in this study indicated that RIT has a potent effect of depleting B cells in the spleen and peripheral blood at low-doses of < 375 mg/m(2).

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal, Murine-Derived
  • B-Lymphocytes / drug effects*
  • Blood Group Incompatibility
  • Desensitization, Immunologic*
  • Female
  • Flow Cytometry
  • Humans
  • Immunohistochemistry
  • Immunologic Factors / administration & dosage*
  • Kidney Transplantation
  • Male
  • Middle Aged
  • Rituximab
  • Spleen / immunology*
  • Splenectomy


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Immunologic Factors
  • Rituximab