15 December 2023 : Original article
Clinical Outcomes of Administration of Rituximab for Desensitization in Liver Transplant Patients with Preformed Donor-Specific Antibodies: A Single-Center Experience
Masato Shizuku
123ABCDEF*, Nobuhiko Kurata 1B, Kanta Jobara 1B, Yasuhiro Fujimoto 1B, Yasuhiro Ogura 1ABCDFG
DOI: 10.12659/AOT.941456
Ann Transplant 2023; 28:e941456
Table 1 Patient characteristics.
| Variables | Patients with pDSA | Patients without pDSA (n=97) | p | |
|---|---|---|---|---|
| Rituximab (+) (n=18) | Rituximab (−) (n=5) | |||
| Age, years (median, range) | 52.0 (29–67) | 44.0 (35–61) | 50.1 (18–66) | 0.23 |
| Gender (Male/Female) | 1/17 | 1/4 | 51/46 | |
| BMI (median) | 20.8 | 22.4 | 23.1 | 0.44 |
| Follow-up period, month (median,range) | 49.5 (8–91) | 26.9 (13–64) | 36.7 (1–84) | 0.29 |
| Primary disease | ||||
| Primary biliary cholangitis | 5 | 0 | 6 | |
| Non-B, C liver cirrhosis | 5 | 0 | 3 | |
| Primary sclerosing cholangitis | 2 | 2 | 19 | |
| Nonalcoholic steatohepatitis | 1 | 1 | 7 | |
| Budd-Chiari syndrome | 1 | 0 | 2 | |
| Caroli disease | 1 | 0 | 0 | |
| Autoimmune hepatitis | 1 | 0 | 5 | |
| Congenital biliary dilatation | 1 | 0 | 0 | |
| Fulminant hepatitis | 1 | 1 | 10 | |
| Graft failure (re-transplantation) | 0 | 1 | 7 | |
| Liver cirrhosis (hepatitis B virus) | 0 | 0 | 10 | |
| Liver cirrhosis (hepatitis C virus) | 0 | 0 | 8 | |
| Alcoholic cirrhosis | 0 | 0 | 4 | |
| Biliary atresia | 0 | 0 | 3 | |
| Non-B, C hepatocellular carcinoma | 0 | 0 | 1 | |
| Wilson disease | 0 | 0 | 2 | |
| Polycystic liver disease | 0 | 0 | 5 | |
| Cholestasis | 0 | 0 | 2 | |
| Idiopathic portal hypertension | 0 | 0 | 1 | |
| Unknown | 0 | 0 | 2 | |
| MELD score (median) | 21 | 25 | 20 | 0.44 |
| Donor (deceased/living) | 5/13 | 4/1 | 30/67 | 0.21 |
| Graft type (whole/right/left) | 5/9/4 | 3/2/0 | 29/60/8 | 0.15 |
| Plasma exchange before LT | 2 | 1 | 16 | 0.82 |
| Graft weight, g (median) | 767 | 1124 | 876 | 0.18 |
| GRWR,% (median, range) | 1.2 (0.9–3.1) | 2.2 (0.9–3.2) | 1.2 (0.8–3.9) | 0.17 |
| Operation time, minutes (median) | 688 | 759 | 738 | 0.26 |
| Blood loss, ml (median) | 8426 | 6623 | 10595 | 0.31 |
| Splenectomy | 5 | 2 | 23 | 0.08 |
| Blood type combination (identical/compatible/incompatible) | 14/2/2 | 5/0/0 | 59/21/17 | 0.14 |
| Rituximab to LT, day (median, range) | 8.0 (1–42) | n.a. | n.a. | |
| Type of pDSA | 0.20 | |||
| Class I only | 7 | 1 | n.a. | |
| Class II only | 7 | 2 | n.a. | |
| Class I+II | 4 | 2 | n.a. | |
| BMI – body mass index; GRWR – graft-to-recipient weight ration; LT – liver transplantation; MELD – model for end-stage liver disease; n.a. – not available; pDSA – preformed donor-specific antibody. | ||||