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27 October 2023 : Original article  

[In Press] Clinical Outcomes of Administration of Rituximab for Desensitization in Liver Transplant Patients with Preformed Donor-Specific Antibodies: A Single-Center Experience

Masato Shizuku ORCID logo123ABCDEF, Nobuhiko Kurata ORCID logo1B, Kanta Jobara ORCID logo1B, Yasuhiro Fujimoto ORCID logo1B, Yasuhiro Ogura ORCID logo1ABCDFG

Ann Transplant In Press; DOI:   :: ID: 941456

Available online: 2023-10-27, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule


The management and fate of liver transplant (LT) recipients with preformed donor-specific antibodies (pDSA) remain controversial. The aim of this study was to evaluate the clinical impact of rituximab desensitization on pDSA in LT recipients.
This retrospective observational study enrolled 120 LT patients aged ≥18 years. Patients with pDSA were administered 500 mg/body rituximab 1-21 days before LT, except for those who had an active infection or had insufficient time to receive rituximab. We allocated patients to groups with or without pDSA, and then divided patients with pDSA into rituximab (+) and rituximab (–) groups for further analysis.
Twenty-three patients (19.2%) with pDSA were identified. Of these, 18 received rituximab and 5 did not receive rituximab. No patients developed adverse events related to rituximab. In both groups, the levels of pDSA class I in all patients were decreased immediately after LT, whereas those of pDSA class II decreased slowly. There were no significant differences in pathology findings and overall survival between patients with pDSA who were rituximab (+) or rituximab (–), and between patients with or without pDSA.
Rituximab desensitization for LT patients with pDSA was managed successfully without significant complications. Due to the small sample size, we could not demonstrate the benefit of rituximab desensitization for LT patients compared with the rituximab (–) group. Additionally, clinical outcomes in patients with pDSA, with or without rituximab, were similar to those without pDSA. Rituximab desensitization might be not essential for LT.

Keywords: Desensitization, Immunologic; Graft Rejection; Liver Transplantation; Rituximab

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358