Impact of rituximab desensitization on blood-type-incompatible adult living donor liver transplantation: A japanese multicenter study

H. Egawa, S. Teramukai, H. Haga, M. Tanabe, A. Mori, Toru Ikegami, N. Kawagishi, H. Ohdan, M. Kasahara, K. Umeshita

研究成果: ジャーナルへの寄稿記事

67 引用 (Scopus)

抄録

We evaluated the effects of rituximab prophylaxis on outcomes of ABO-blood-type-incompatible living donor liver transplantation (ABO-I LDLT) in 381 adult patients in the Japanese registry of ABO-I LDLT. Patients underwent dual or triple immunosuppression with or without B cell desensitization therapies such as plasmapheresis, splenectomy, local infusion, intravenous immunoglobulin and rituximab. Era before 2005, intensive care unit-bound status, high Model for End-Stage Liver Disease score and absence of rituximab prophylaxis were significant risk factors for overall survival and antibody-mediated rejection (AMR) in the univariate analysis. After adjustment for era effects in the multivariate analysis, only absence of rituximab prophylaxis was a significant risk factor for AMR, and there were no significant risk factors for survival. Rituximab prophylaxis significantly decreased the incidence of AMR, especially hepatic necrosis (p < 0.001). In the rituximab group, other B cell desensitization therapies had no add-on effects. Multiple or large rituximab doses significantly increased the incidence of infection, and early administration had no advantage. In conclusion, outcomes in adult ABO-I LDLT have significantly improved in the latest era coincident with the introduction of rituximab. This registry study suggests that rituximab prophylaxis contributes to improved outcomes of adult ABO-incompatible living donor liver transplantation.

元の言語英語
ページ(範囲)102-114
ページ数13
ジャーナルAmerican Journal of Transplantation
14
発行部数1
DOI
出版物ステータス出版済み - 1 1 2014

Fingerprint

Living Donors
Liver Transplantation
Multicenter Studies
Cell- and Tissue-Based Therapy
Registries
Antibodies
B-Lymphocytes
Rituximab
End Stage Liver Disease
Plasmapheresis
Survival
Intravenous Immunoglobulins
Incidence
Splenectomy
Immunosuppression
Intensive Care Units
Necrosis
Multivariate Analysis
Liver

All Science Journal Classification (ASJC) codes

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

これを引用

Impact of rituximab desensitization on blood-type-incompatible adult living donor liver transplantation : A japanese multicenter study. / Egawa, H.; Teramukai, S.; Haga, H.; Tanabe, M.; Mori, A.; Ikegami, Toru; Kawagishi, N.; Ohdan, H.; Kasahara, M.; Umeshita, K.

:: American Journal of Transplantation, 巻 14, 番号 1, 01.01.2014, p. 102-114.

研究成果: ジャーナルへの寄稿記事

Egawa, H, Teramukai, S, Haga, H, Tanabe, M, Mori, A, Ikegami, T, Kawagishi, N, Ohdan, H, Kasahara, M & Umeshita, K 2014, 'Impact of rituximab desensitization on blood-type-incompatible adult living donor liver transplantation: A japanese multicenter study', American Journal of Transplantation, 巻. 14, 番号 1, pp. 102-114. https://doi.org/10.1111/ajt.12520
Egawa, H. ; Teramukai, S. ; Haga, H. ; Tanabe, M. ; Mori, A. ; Ikegami, Toru ; Kawagishi, N. ; Ohdan, H. ; Kasahara, M. ; Umeshita, K. / Impact of rituximab desensitization on blood-type-incompatible adult living donor liver transplantation : A japanese multicenter study. :: American Journal of Transplantation. 2014 ; 巻 14, 番号 1. pp. 102-114.
@article{15bfa89cda4a4bea9b72febc3f67058e,
title = "Impact of rituximab desensitization on blood-type-incompatible adult living donor liver transplantation: A japanese multicenter study",
abstract = "We evaluated the effects of rituximab prophylaxis on outcomes of ABO-blood-type-incompatible living donor liver transplantation (ABO-I LDLT) in 381 adult patients in the Japanese registry of ABO-I LDLT. Patients underwent dual or triple immunosuppression with or without B cell desensitization therapies such as plasmapheresis, splenectomy, local infusion, intravenous immunoglobulin and rituximab. Era before 2005, intensive care unit-bound status, high Model for End-Stage Liver Disease score and absence of rituximab prophylaxis were significant risk factors for overall survival and antibody-mediated rejection (AMR) in the univariate analysis. After adjustment for era effects in the multivariate analysis, only absence of rituximab prophylaxis was a significant risk factor for AMR, and there were no significant risk factors for survival. Rituximab prophylaxis significantly decreased the incidence of AMR, especially hepatic necrosis (p < 0.001). In the rituximab group, other B cell desensitization therapies had no add-on effects. Multiple or large rituximab doses significantly increased the incidence of infection, and early administration had no advantage. In conclusion, outcomes in adult ABO-I LDLT have significantly improved in the latest era coincident with the introduction of rituximab. This registry study suggests that rituximab prophylaxis contributes to improved outcomes of adult ABO-incompatible living donor liver transplantation.",
author = "H. Egawa and S. Teramukai and H. Haga and M. Tanabe and A. Mori and Toru Ikegami and N. Kawagishi and H. Ohdan and M. Kasahara and K. Umeshita",
year = "2014",
month = "1",
day = "1",
doi = "10.1111/ajt.12520",
language = "English",
volume = "14",
pages = "102--114",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Impact of rituximab desensitization on blood-type-incompatible adult living donor liver transplantation

T2 - A japanese multicenter study

AU - Egawa, H.

AU - Teramukai, S.

AU - Haga, H.

AU - Tanabe, M.

AU - Mori, A.

AU - Ikegami, Toru

AU - Kawagishi, N.

AU - Ohdan, H.

AU - Kasahara, M.

AU - Umeshita, K.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - We evaluated the effects of rituximab prophylaxis on outcomes of ABO-blood-type-incompatible living donor liver transplantation (ABO-I LDLT) in 381 adult patients in the Japanese registry of ABO-I LDLT. Patients underwent dual or triple immunosuppression with or without B cell desensitization therapies such as plasmapheresis, splenectomy, local infusion, intravenous immunoglobulin and rituximab. Era before 2005, intensive care unit-bound status, high Model for End-Stage Liver Disease score and absence of rituximab prophylaxis were significant risk factors for overall survival and antibody-mediated rejection (AMR) in the univariate analysis. After adjustment for era effects in the multivariate analysis, only absence of rituximab prophylaxis was a significant risk factor for AMR, and there were no significant risk factors for survival. Rituximab prophylaxis significantly decreased the incidence of AMR, especially hepatic necrosis (p < 0.001). In the rituximab group, other B cell desensitization therapies had no add-on effects. Multiple or large rituximab doses significantly increased the incidence of infection, and early administration had no advantage. In conclusion, outcomes in adult ABO-I LDLT have significantly improved in the latest era coincident with the introduction of rituximab. This registry study suggests that rituximab prophylaxis contributes to improved outcomes of adult ABO-incompatible living donor liver transplantation.

AB - We evaluated the effects of rituximab prophylaxis on outcomes of ABO-blood-type-incompatible living donor liver transplantation (ABO-I LDLT) in 381 adult patients in the Japanese registry of ABO-I LDLT. Patients underwent dual or triple immunosuppression with or without B cell desensitization therapies such as plasmapheresis, splenectomy, local infusion, intravenous immunoglobulin and rituximab. Era before 2005, intensive care unit-bound status, high Model for End-Stage Liver Disease score and absence of rituximab prophylaxis were significant risk factors for overall survival and antibody-mediated rejection (AMR) in the univariate analysis. After adjustment for era effects in the multivariate analysis, only absence of rituximab prophylaxis was a significant risk factor for AMR, and there were no significant risk factors for survival. Rituximab prophylaxis significantly decreased the incidence of AMR, especially hepatic necrosis (p < 0.001). In the rituximab group, other B cell desensitization therapies had no add-on effects. Multiple or large rituximab doses significantly increased the incidence of infection, and early administration had no advantage. In conclusion, outcomes in adult ABO-I LDLT have significantly improved in the latest era coincident with the introduction of rituximab. This registry study suggests that rituximab prophylaxis contributes to improved outcomes of adult ABO-incompatible living donor liver transplantation.

UR - http://www.scopus.com/inward/record.url?scp=84890984300&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84890984300&partnerID=8YFLogxK

U2 - 10.1111/ajt.12520

DO - 10.1111/ajt.12520

M3 - Article

C2 - 24279828

AN - SCOPUS:84890984300

VL - 14

SP - 102

EP - 114

JO - American Journal of Transplantation

JF - American Journal of Transplantation

SN - 1600-6135

IS - 1

ER -