Introduction:
Antibody-mediated rejections are the most common cause of graft loss. Induction therapy with ATG is T cell centric leaving B cells uninhibited leading to acute rejections and antibody-mediated IF/TA in the long term. Combined T cell and B cell inhibition might prevent Acute rejections, ABMR and improve graft survival.
Methods:
In this non-randomized controlled clinical study, we compared the efficacy of adding rituximab to the standard rATG regimen versus rATG alone in ABO-compatible nonsensitized live recipients to prevent rejection. ATG was administered at 3mg/kg beginning at intra intraoperative period. Rituximab was administered at 150mg/m² on POD -1—maintenance immunosuppression with Tacrolimus, MMF, and steroids in all patients. The primary aim is to determine the incidence of acute rejection. The secondary aim is the incidence of infections, and patient and graft survival
Results:
64 patients were included in the study period of April 2023 to June 2024. 39 patients received rATG alone. 25 Patients received rATG + Rituximab. No difference between baseline demographics in both groups. No patient developed biopsy-proven acute rejection in the rATG+ rituximab group (0 vs 15%) which was statistically significant (P -0.04). The incidence of infections was similar between both groups (24 % vs20 % P– 0.758). Graft survival was similar between the groups (100% vs 98.5% p – 0.42). Patient survival was similar in both groups (100% vs 98.5% p – 0.42). ). No opportunistic infection developed in either group.
Conclusions:
The addition of rituximab to rATG reduced the incidence of acute rejection without infectious complications. However, patient-centered outcomes of patient and graft survival were similar between both groups. larger trials are needed to confirm the findings.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.