Evaluation of Rituximab Dosage for XXXX -Incompatible Living-donor Kidney Transplantation.

@entity1 @entity8 @entity6910 @entity1956 @entity2225 @entity1800
BACKGROUND: The introduction of rituximab has led to a growing tendency to perform @entity6910 -incompatible @entity8 ( @entity8 ) without splenectomy. However, the optimal dosage of rituximab is undefined. METHOD: Fifty-five @entity8 recipients who had neither a history of @entity1956 nor positive crossmatch were enrolled between October 2005 and June 2014. Recipients were divided into three groups by year of transplantation: 2005 to 2008; 2009 to 2011; and 2012 to 2014. Percentages of @entity2225 -positive B lymphocytes and blood-group antibody titers were monitored before renal transplantation. An initial rituximab dosage of 100 mg/body (for titers below 64) or 200 mg/body (for titers above 128) was administered 2 weeks before transplantation. If the percentage of peripheral B lymphocytes remained greater than 0.5%, additional rituximab (100  mg or 200  mg) was administered. @entity1 demographics, @entity1 survival, graft survival, and complication rates were compared. RESULTS: Nine @entity1 received rituximab 100 mg/body (low-dose rituximab [LDR] group). Overall survival and graft survival rates did not differ significantly between the LDR group and other cases. The incidences of myelosuppression and @entity1800 were lower in the LDR group than the other cases. CONCLUSION: A low dose of rituximab (100 mg/body) is adequate in @entity6910 -incompatible @entity8 , especially in cases with low blood-type antibody titer against @entity6910 -antigens. Rituximab dosage reduction has been successful in our hospital without serious complications. Moreover, as over-dosage of rituximab may cause myelosuppression, it is reasonable to believe that LDR is a suitable option to safely perform @entity6910 -incompatible @entity8 without splenectomy.
