Evaluation of low-dose rituximab induction therapy in living related kidney transplantation

Transplantation. 2010 Jun 27;89(12):1466-70. doi: 10.1097/TP.0b013e3181dc0999.


Background: Rrituximab has been used for desensitization of anti-blood type antibody and anti-human leukocyte antigen (HLA) antibody as an induction immunosuppressant in our hospital. After having used rituximab for more than 2 years, we performed a retrospective study to clarify the effectiveness and safety of rituximab.

Materials and methods: We performed 144 kidney transplants between January 2005 and December 2007 at our hospital. Low-dose rituximab was administered to 78 of these transplant recipients as an induction immunosuppressant. A comparison of viral infection, leucopenia, and rejection incidence between patients administered (Rit group) and not administered (Non-Rit group) rituximab before kidney transplantation was performed.

Result: A comparison of Rit group and Non-Rit group revealed no significant difference in the incidence of cytomegalovirus infections (Rit: 26%, Non-Rit: 29%; P=1.00), BK virus infections (Rit: 2.6%, Non-Rit: 0%; P=0.53), or leukopenia (Rit:23%, Non-Rit: 14%; P=0.25) between the two groups of patients. The incidence of acute antibody-mediated rejection was also not significantly different between the two groups (Rit: 6.8%, Non-Rit: 8.3%; P=0.75). On the other hand, the incidence of acute T-cell-mediated rejection was significantly lower in the Rit group (Rit: 8.2%, Non-Rit: 23.3%; P<0.05). Anti-HLA antibodies belonging to HLA class 1 and class 2 were depleted by 70% and 83%, respectively, for more than 2 years after rituximab administration.

Conclusions: We could confirm the effectiveness and safety of rituximab more than 2-year follow-up period.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Murine-Derived
  • Female
  • HLA Antigens / immunology
  • Humans
  • Immunologic Factors / therapeutic use*
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / immunology
  • Kidney Transplantation / methods*
  • Leukopenia / pathology
  • Living Donors
  • Male
  • Middle Aged
  • Retrospective Studies
  • Rituximab
  • Treatment Outcome
  • gamma-Globulins / metabolism


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • HLA Antigens
  • Immunologic Factors
  • Immunosuppressive Agents
  • gamma-Globulins
  • Rituximab