利妥昔单抗在肾移植后抗体介导排斥反应中的作用

Clinical application of rituximab in antibody mediated rejection after renal transplantation

背景:国外研究表明,利妥昔单抗在肾移植后抗体介导的排斥反应中具有良好的安全性及有效性,但中国尚缺乏此类研究及报道。目的:探讨利妥昔单抗在肾移植后抗体介导的排斥反应中的安全性和有效性。方法:将肾移植后病理诊断为抗体介导的排斥反应的患者18例分为2组,均进行免疫抑制治疗,药物组8例采用单剂利妥昔单抗治疗;对照组10例不使用利妥昔单抗治疗。结果与结论:用药后6,12个月,药物组肌酐水平均低于同期对照组(P<0.05)。用药后随访6-12个月,药物组1例患者出现巨细胞病毒血症,1例患者出现泌尿系感染,随访期间无威胁生命的感染发生,人/肾存活率为100%。结果证实,利妥昔单抗在治疗肾移植移植后抗体介导的排斥反应中安全有效。

BACKGROUND： Foreign literatures show that the application of rituximab in antibody mediated rejection after renal transplantation has significant efficacy and good safety. But there still lacks of report and research of these in China OBJECTIVE： To investigate the efficacy and safety of rituximab in the treatment of antibody mediated rejection after renal transplantation. METHODS： Eighteen patients who diagnosed with antibody mediated rejection after renal transplantation were divided into two groups, and all the patients in two groups received immunosuppressive therapy. Patients in the experimental group （n=8） received single dose rituximab treatment; patients in the control group （n=10） were treated without single dose rituximab treatment. RESULTS AND CONCLUSION： After treated for 6 and 12 months, the creatinine level in the experimental group was lower than that in the control group （P 〈 0.05）. After 6 12 months follow-up, in experimental group, one patient with cytomegaoviyns, one patient with urinary tract infection, no life-threatening infection during the follow-up period, and the patient/graft survival rate was 100%. It indicates that rituximab for the treatment of antibody mediated rejection after renal transplantation has significant efficacy and good safety.