ORIGINAL ARTICLE

The efficacy of rituximab treatment for antibody-mediated rejection in liver transplantation: A retrospective Japanese nationwide study

Corresponding Author

Seisuke Sakamoto

[email protected]

Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan

Correspondence

Seisuke Sakamoto, Organ Transplantation Center, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan.

Email: [email protected]

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Nobuhisa Akamatsu,

Nobuhisa Akamatsu

Artificial Organ and Transplantation Surgery Division, Department of Surgery, Tokyo University Graduate School of Medicine, Tokyo, Japan

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Kiyoshi Hasegawa,

Kiyoshi Hasegawa

orcid.org/0000-0001-8734-740X

Artificial Organ and Transplantation Surgery Division, Department of Surgery, Tokyo University Graduate School of Medicine, Tokyo, Japan

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Hideki Ohdan,

Hideki Ohdan

Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

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Ken Nakagawa,

Ken Nakagawa

Department of Urology, Ichikawa General Hospital Tokyo Dental College, Chiba, Japan

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Hiroto Egawa,

Hiroto Egawa

Department of Gastroenterological Surgery, Institute of Gastroenterology, Tokyo Women's Medical University of Medicine, Tokyo, Japan

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Seisuke Sakamoto,

Corresponding Author

Seisuke Sakamoto

[email protected]

Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan

Correspondence

Seisuke Sakamoto, Organ Transplantation Center, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan.

Email: [email protected]

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Nobuhisa Akamatsu,

Nobuhisa Akamatsu

Artificial Organ and Transplantation Surgery Division, Department of Surgery, Tokyo University Graduate School of Medicine, Tokyo, Japan

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Kiyoshi Hasegawa,

Kiyoshi Hasegawa

orcid.org/0000-0001-8734-740X

Artificial Organ and Transplantation Surgery Division, Department of Surgery, Tokyo University Graduate School of Medicine, Tokyo, Japan

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Hideki Ohdan,

Hideki Ohdan

Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

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Ken Nakagawa,

Ken Nakagawa

Department of Urology, Ichikawa General Hospital Tokyo Dental College, Chiba, Japan

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Hiroto Egawa,

Hiroto Egawa

Department of Gastroenterological Surgery, Institute of Gastroenterology, Tokyo Women's Medical University of Medicine, Tokyo, Japan

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First published: 05 April 2021

https://doi.org/10.1111/hepr.13643

Citations: 8

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Abstract

Aim

Antibody-mediated rejection (AMR) has been consistently elucidated in liver transplantation (LT); however, the treatment for AMR, including rituximab, has not been indicated as a strongly recommended therapeutic protocol.

Methods

This study was conducted as the Japanese multicenter retrospective study to accumulate data on the use of rituximab for AMR among patients undergoing LT between August 2001 and December 2016. Thirteen patients (five children and eight adults) were enrolled.

Results

The types of AMR in the pediatric cases were chronic AMR in four cases and indeterminate AMR in one case. Among the pediatric cases, rituximab treatment only showed therapeutic efficacy in two patients with chronic AMR. Among the adult patients, five patients had chronic AMR, and three had acute AMR. Although two patients with chronic AMR died due to graft failure, liver function tests revealed improvement after rituximab treatment in the other patients. Two of the three patients with acute AMR died due to graft failure; rituximab treatment showed no therapeutic efficacy in these cases. Although bacterial infections occurred within 3 months after rituximab administration in three patients, rituximab treatment could be safely administered without any direct adverse effects.

Conclusions

The indication of rituximab therapy as an additional treatment for mild acute AMR and chronic AMR may be feasible; however, a prospective randomized control study is needed to evaluate the therapeutic efficacy of rituximab treatment for AMR.

CONFLICT OF INTEREST

The authors have no conflict of interest.

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Volume51, Issue9

September 2021

Pages 990-999

The efficacy of rituximab treatment for antibody-mediated rejection in liver transplantation: A retrospective Japanese nationwide study

Abstract

Aim

Methods

Results

Conclusions

CONFLICT OF INTEREST

REFERENCES

Citing Literature

References

Information

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The efficacy of rituximab treatment for antibody-mediated rejection in liver transplantation: A retrospective Japanese nationwide study

Abstract

Aim

Methods

Results

Conclusions

CONFLICT OF INTEREST

REFERENCES

Citing Literature

References

Related

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