2015•Nephrology Dialysis TransplantationOpen access

SP808EARLY VS. LATE ACUTE ANTIBODY MEDIATED REJECTION AMONG RENAL TRANSPLANT RECIPIENTS IN TERMS OF ITS RESPONSE TO RITUXIMAB THERAPY-SINGLE CENTER EXPEREINCE

Osama Ashry Ahmed Gheith, Torki Al-Otaibi, Naryanan Nampoory, Medhat A Halim, Tarek Said, Prasad M. Nair, Mohamed Abdul Moneim, Salah Al-Waheeb, Rashad Hasan

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Abstract

Introduction and Aims: There are no comparable trials concerning the use of rituximab among renal transplant recipients with acute antibody mediated rejection. Aim of the study: We aimed to compare early and late acute AAMR among renal transplant recipientsin terms of its response to rituximab therapy. Methods: Out of 1200 kidney transplant recipients performed in Hamed Al-Essa Organ Transplant Center of Kuwait over the last 10 years, 103 developed acute AAMR and were subcategorized into 4 groups according to the onset of rejection and rituximab management. All patients received the standard management of AAMR according to our protocol (PP and IVIG). We added rituximab to the management of cases of group 1 (n=27, early AAMR) and group 2(n=38,late AAMR) while groups 3and 4 represented non-rituximab groups (n=20,early AAMR&18,late AAMR respectively).We compared the 4 groups regardinggraft and patientoutcome. Results: All patients were comparable regarding demographic data (patient age, sex, pre-transplant type of dialysis viral profile, type of induction, donor criteria, and pretransplant co-morbidities).we observed that delayed and slow graft function were significantly higher in groups 1,3(p=0.016), however we found no significant difference in the 4 groups regarding NODAT,BK viral infection or malignancy. Graft outcome was significantly better in group 1, 2 compared to the other groups (p=0.028). However, patient outcome was comparable in the 4 groups (p>0.05).

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Introduction and Aims: There are no comparable trials concerning the use of rituximab among renal transplant recipients with acute antibody mediated rejection. Aim of the study: We aimed to compare early and late acute AAMR among renal transplant recipientsin terms of its response to rituximab therapy. Methods: Out of 1200 kidney transplant recipients performed in Hamed Al-Essa Organ Transplant Center of Kuwait over the last 10 years, 103 developed acute AAMR and were subcategorized into 4 groups according to the onset of rejection and rituximab management. All patients received the standard management of AAMR according to our protocol (PP and IVIG). We added rituximab to the management of cases of group 1 (n=27, early AAMR) and group 2(n=38,late AAMR) while groups 3and 4 represented non-rituximab groups (n=20,early AAMR&18,late AAMR respectively).We compared the 4 groups regardinggraft and patientoutcome. Results: All patients were comparable regarding demographic data (patient age, sex, pre-transplant type of dialysis viral profile, type of induction, donor criteria, and pretransplant co-morbidities).we observed that delayed and slow graft function were significantly higher in groups 1,3(p=0.016), however we found no significant difference in the 4 groups regarding NODAT,BK viral infection or malignancy. Graft outcome was significantly better in group 1, 2 compared to the other groups (p=0.028). However, patient outcome was comparable in the 4 groups (p>0.05).

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Available abstract

Introduction and Aims: There are no comparable trials concerning the use of rituximab among renal transplant recipients with acute antibody mediated rejection. Aim of the study: We aimed to compare early and late acute AAMR among renal transplant recipientsin terms of its response to rituximab therapy. Methods: Out of 1200 kidney transplant recipients performed in Hamed Al-Essa Organ Transplant Center of Kuwait over the last 10 years, 103 developed acute AAMR and were subcategorized into 4 groups according to the onset of rejection and rituximab management. All patients received the standard management of AAMR according to our protocol (PP and IVIG). We added rituximab to the management of cases of group 1 (n=27, early AAMR) and group 2(n=38,late AAMR) while groups 3and 4 represented non-rituximab groups (n=20,early AAMR&18,late AAMR respectively).We compared the 4 groups regardinggraft and patientoutcome. Results: All patients were comparable regarding demographic data (patient age, sex, pre-transplant type of dialysis viral profile, type of induction, donor criteria, and pretransplant co-morbidities).we observed that delayed and slow graft function were significantly higher in groups 1,3(p=0.016), however we found no significant difference in the 4 groups regarding NODAT,BK viral infection or malignancy. Graft outcome was significantly better in group 1, 2 compared to the other groups (p=0.028). However, patient outcome was comparable in the 4 groups (p>0.05).

Key concepts: Medicine, Rituximab, Renal transplant, Antibody response, Single Center, Immunology, Antibody, Internal medicine

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SP808EARLY VS. LATE ACUTE ANTIBODY MEDIATED REJECTION AMONG RENAL TRANSPLANT RECIPIENTS IN TERMS OF ITS RESPONSE TO RITUXIMAB THERAPY-SINGLE CENTER EXPEREINCE — Research Paper | ScholarLens