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Lehnhardt, Anja M.; Strecker, Maximiliane; Eiermann, Thomas; Marget, Matthias; Thaiss, Friedrich; Nashan, Björn; Koch, Martina

High B‐cell activating factor is not associated with worse 3‐year graft outcome in blood group‐incompatible kidney transplantation with rituximab induction

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  • Media type: E-Article
  • Title: High B‐cell activating factor is not associated with worse 3‐year graft outcome in blood group‐incompatible kidney transplantation with rituximab induction
  • Contributor: Lehnhardt, Anja M.; Strecker, Maximiliane; Eiermann, Thomas; Marget, Matthias; Thaiss, Friedrich; Nashan, Björn; Koch, Martina
  • imprint: Wiley, 2015
  • Published in: Clinical Transplantation
  • Language: English
  • DOI: 10.1111/ctr.12523
  • ISSN: 1399-0012; 0902-0063
  • Keywords: Transplantation
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:p>B cells and their regulation by B‐cell activating factor <jats:styled-content style="fixed-case">BAFF</jats:styled-content> are of growing interest in kidney transplantation (<jats:styled-content style="fixed-case">KT</jats:styled-content>x). There is evidence that high serum (s) <jats:styled-content style="fixed-case">BAFF</jats:styled-content> leads to increased allosensitization and impaired long‐term graft function. We prospectively investigated <jats:styled-content style="fixed-case">sBAFF</jats:styled-content>, peripheral blood lymphocytes (<jats:styled-content style="fixed-case">PBL</jats:styled-content>), and donor‐specific <jats:styled-content style="fixed-case">HLA</jats:styled-content> antibodies (<jats:styled-content style="fixed-case">DSA</jats:styled-content>) in patients after <jats:styled-content style="fixed-case">ABO</jats:styled-content>i with B‐cell depleting rituximab induction treatment and compared them to a group of blood group‐compatible (<jats:styled-content style="fixed-case">ABO</jats:styled-content>c) living donor kidney recipients. Twelve patients after <jats:styled-content style="fixed-case">ABO</jats:styled-content>i and 18 after <jats:styled-content style="fixed-case">ABO</jats:styled-content>c were included. After rituximab treatment prior to <jats:styled-content style="fixed-case">ABO</jats:styled-content>i, B cells remained significantly lower 1 year after <jats:styled-content style="fixed-case">KT</jats:styled-content>x (1.2% (0.0–17.8) compared to <jats:styled-content style="fixed-case">ABO</jats:styled-content>c of 8.6% (2.8–35.0), p<jats:italic> = 0.0004</jats:italic>, and also <jats:styled-content style="fixed-case">BAFF</jats:styled-content>‐R expression was significantly lower in <jats:styled-content style="fixed-case">ABO</jats:styled-content>i <jats:italic>(p &lt; 0.006)</jats:italic>. <jats:styled-content style="fixed-case">sBAFF</jats:styled-content> remained elevated 1 year post‐Tx compared to <jats:styled-content style="fixed-case">ABO</jats:styled-content>c (3615 ± 1800 vs. 1394 ± 493 pg/mL, <jats:italic>p &lt; 0.004)</jats:italic>. Kidney function was not significantly different between both groups after 1, 2, and 3 years. The use of rituximab in <jats:styled-content style="fixed-case">ABO</jats:styled-content>i together with maintenance immunosuppression leads to significant elevation of <jats:styled-content style="fixed-case">sBAFF</jats:styled-content> and lowering of B‐cell numbers for more than 1 year, and this does not correlate with worse 3‐year graft outcome.</jats:p>