treatment of acute antibody-mediated rejection using rituximab

Introduction: one of the optimal therapies for most of the end-stage renal disease (esrd) patients is transplantation. acute antibody mediated rejection is one type of acute rejection in which antibodies are directed against donor specific human leukocyte antigen (hla). rituximab is one kind of the drugs used for amr treatment based on elimination of circulating ab. it is a chimeric monoclonal ab which is specific for human b lymphocyte– restricted differentiation antigen (cd20). concerning the incidence of amr in transplantation, existence of resistance to usual amr therapy and their poor outcomes, we decided to use rituximab (rtx) in treatment of amr and to study its outcomes. material/patients: all patients who underwent renal transplantation from 2009 to 2014 in chamran and labbafinejad centers enrolled. these patients further receiving conventional therapy amr (tacrolimus + cellcept + corticosteroids ± pp), were treated with one or two dosage of rtx 500mg and the graft`s response and the patient's response to rtx were studied. results: after 5-11 months follow-up, patients’ survival was 100% and grafts survival was 77%. in 17 patients renal function improved which the average creatinine (cr) in the first month after treatment was 1.6+/-0.5 (p<0.001) and the average cr in 6 month was 1.5+/- 0.8 (p<0.001).conclusion: in comparison with outcomes reported before in treatment of amr, our study obtained excellent outcomes in patient and graft survival (100% and 77% respectively). our findings suggest that the usage of rtx in the treatment of amr at least in short and medium term may be effective.