The impact of rituximab in ABO-incompatible pediatric living donor liver transplantation: The experience of a single center
Corresponding Author
Noriki Okada
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Noriki Okada, Department of Transplant Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi-ken 329-0498, Japan
Tel.: +81-285-44-2111
Fax: +81-285-44-3234
E-mail: [email protected]
Search for more papers by this authorYukihiro Sanada
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorYuta Hirata
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorNaoya Yamada
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorTaiichi Wakiya
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorYoshiyuki Ihara
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorTaizen Urahashi
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorAtsushi Miki
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorYuji Kaneda
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorHideki Sasanuma
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorTakehito Fujiwara
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorYasunaru Sakuma
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorAtsushi Shimizu
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorMasanobu Hyodo
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorYoshikazu Yasuda
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorKoichi Mizuta
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorCorresponding Author
Noriki Okada
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Noriki Okada, Department of Transplant Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi-ken 329-0498, Japan
Tel.: +81-285-44-2111
Fax: +81-285-44-3234
E-mail: [email protected]
Search for more papers by this authorYukihiro Sanada
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorYuta Hirata
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorNaoya Yamada
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorTaiichi Wakiya
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorYoshiyuki Ihara
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorTaizen Urahashi
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorAtsushi Miki
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorYuji Kaneda
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorHideki Sasanuma
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorTakehito Fujiwara
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorYasunaru Sakuma
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorAtsushi Shimizu
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorMasanobu Hyodo
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorYoshikazu Yasuda
Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorKoichi Mizuta
Department of Transplant Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan
Search for more papers by this authorAbstract
Previous studies have demonstrated the safety of ABO-incompatible pediatric LDLT using preoperative plasmapheresis and rituximab; however, no reports have described the timing and dosage of rituximab administration for pediatric LDLT. This study aimed to describe a safe and effective dosage and timing of rituximab for patients undergoing pediatric ABO-incompatible LDLT based on the experience of our single center. A total of 192 LDLTs in 187 patients were examined. These cases included 29 ABO-incompatible LDLTs in 28 patients. Rituximab was used beginning in January 2004 in recipients older than two yr of age (first period: 375 mg/m2 in two cases; second period: 50 mg/m2 in two cases; and 200 mg/m2 in eight cases). Two patients who received 375 mg/m2 rituximab died of Pneumocystis carinii pneumonia and hemophagocytic syndrome. One patient who received 50 mg/m2 rituximab required retransplantation as a consequence of antibody-mediated complications. All eight patients administered 200 mg/m2 survived, and the mean CD20+ lymphocyte count was 0.1% at the time of LDLT. In the preoperative management of patients undergoing pediatric ABO-incompatible LDLT, the administration of 200 mg/m2 rituximab three wk prior to LDLT was safe and effective.
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