Cargando…

Factors associated with rituximab-mediated B cell depletion in ABO-incompatible adult living donor liver transplantation

BACKGROUND: Pretransplant therapies such as rituximab and plasmapheresis have led to an increase in ABO-incompatible (ABOi) living donor liver transplantation (LDLT), thus helping to overcome organ shortages. This study evaluated the changes in anti-A/B titers and CD19 levels over time in patients u...

Descripción completa

Detalles Bibliográficos
Autores principales: Hong, Suk Kyun, Lee, Kwang-Woong, Kim, Jae-Yoon, Lee, Jaewon, Kim, Jiyoung, Choi, Hyun Hwa, Hong, Su young, Lee, Jeong-Moo, Choi, YoungRok, Yi, Nam-Joon, Suh, Kyung-Suk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Transplantation 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10583967/
https://www.ncbi.nlm.nih.gov/pubmed/37694598
http://dx.doi.org/10.4285/kjt.23.0031
_version_ 1785122659900588032
author Hong, Suk Kyun
Lee, Kwang-Woong
Kim, Jae-Yoon
Lee, Jaewon
Kim, Jiyoung
Choi, Hyun Hwa
Hong, Su young
Lee, Jeong-Moo
Choi, YoungRok
Yi, Nam-Joon
Suh, Kyung-Suk
author_facet Hong, Suk Kyun
Lee, Kwang-Woong
Kim, Jae-Yoon
Lee, Jaewon
Kim, Jiyoung
Choi, Hyun Hwa
Hong, Su young
Lee, Jeong-Moo
Choi, YoungRok
Yi, Nam-Joon
Suh, Kyung-Suk
author_sort Hong, Suk Kyun
collection PubMed
description BACKGROUND: Pretransplant therapies such as rituximab and plasmapheresis have led to an increase in ABO-incompatible (ABOi) living donor liver transplantation (LDLT), thus helping to overcome organ shortages. This study evaluated the changes in anti-A/B titers and CD19 levels over time in patients undergoing ABOi LT and aimed to understand the effect of single-nucleotide polymorphisms (SNPs) in Fc gamma receptor (FcγR) on rituximab therapy. METHODS: Two SNPs of FCGR2A (131H/R) and FCGR3A (158F/V) were identified. The clinical data on 44 patients who underwent ABOi LDLT between May 2019 and October 2021 at Seoul National University Hospital were reviewed retrospectively. RESULTS: Following desensitization with rituximab and subsequent LDLT, the anti-A/B titer recovered within 1 week, but decreased thereafter. The CD19 level increased at 3 months after LT. The genotyping data for FCGR3A (158F/V) indicated that two patients had the V/V genotype, and 42 had the F/V genotype. In the genotyping data for FCGR2A (131H/R), 21 patients had the H/H genotype, three had the R/R genotype, and 20 had the H/R genotype. However, there were no significant differences in anti-A/B and CD19 levels, bacteremia rates, T cell-mediated rejection, antibody-mediated rejection, or the survival rate among the FCGR2A types. CONCLUSIONS: There were significant changes in the anti-A/B titers and CD19 levels over time in each patient after ABOi LDLT. The difference in outcomes following LT according to the FcγR SNP type for rituximab was unclear. Further studies with larger sample sizes are needed to confirm the effect of FcγR SNPs on rituximab therapy.
format Online
Article
Text
id pubmed-10583967
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher The Korean Society for Transplantation
record_format MEDLINE/PubMed
spelling pubmed-105839672023-10-19 Factors associated with rituximab-mediated B cell depletion in ABO-incompatible adult living donor liver transplantation Hong, Suk Kyun Lee, Kwang-Woong Kim, Jae-Yoon Lee, Jaewon Kim, Jiyoung Choi, Hyun Hwa Hong, Su young Lee, Jeong-Moo Choi, YoungRok Yi, Nam-Joon Suh, Kyung-Suk Korean J Transplant Original Article BACKGROUND: Pretransplant therapies such as rituximab and plasmapheresis have led to an increase in ABO-incompatible (ABOi) living donor liver transplantation (LDLT), thus helping to overcome organ shortages. This study evaluated the changes in anti-A/B titers and CD19 levels over time in patients undergoing ABOi LT and aimed to understand the effect of single-nucleotide polymorphisms (SNPs) in Fc gamma receptor (FcγR) on rituximab therapy. METHODS: Two SNPs of FCGR2A (131H/R) and FCGR3A (158F/V) were identified. The clinical data on 44 patients who underwent ABOi LDLT between May 2019 and October 2021 at Seoul National University Hospital were reviewed retrospectively. RESULTS: Following desensitization with rituximab and subsequent LDLT, the anti-A/B titer recovered within 1 week, but decreased thereafter. The CD19 level increased at 3 months after LT. The genotyping data for FCGR3A (158F/V) indicated that two patients had the V/V genotype, and 42 had the F/V genotype. In the genotyping data for FCGR2A (131H/R), 21 patients had the H/H genotype, three had the R/R genotype, and 20 had the H/R genotype. However, there were no significant differences in anti-A/B and CD19 levels, bacteremia rates, T cell-mediated rejection, antibody-mediated rejection, or the survival rate among the FCGR2A types. CONCLUSIONS: There were significant changes in the anti-A/B titers and CD19 levels over time in each patient after ABOi LDLT. The difference in outcomes following LT according to the FcγR SNP type for rituximab was unclear. Further studies with larger sample sizes are needed to confirm the effect of FcγR SNPs on rituximab therapy. The Korean Society for Transplantation 2023-09-30 2023-09-11 /pmc/articles/PMC10583967/ /pubmed/37694598 http://dx.doi.org/10.4285/kjt.23.0031 Text en Copyright © 2023 The Korean Society for Transplantation https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hong, Suk Kyun
Lee, Kwang-Woong
Kim, Jae-Yoon
Lee, Jaewon
Kim, Jiyoung
Choi, Hyun Hwa
Hong, Su young
Lee, Jeong-Moo
Choi, YoungRok
Yi, Nam-Joon
Suh, Kyung-Suk
Factors associated with rituximab-mediated B cell depletion in ABO-incompatible adult living donor liver transplantation
title Factors associated with rituximab-mediated B cell depletion in ABO-incompatible adult living donor liver transplantation
title_full Factors associated with rituximab-mediated B cell depletion in ABO-incompatible adult living donor liver transplantation
title_fullStr Factors associated with rituximab-mediated B cell depletion in ABO-incompatible adult living donor liver transplantation
title_full_unstemmed Factors associated with rituximab-mediated B cell depletion in ABO-incompatible adult living donor liver transplantation
title_short Factors associated with rituximab-mediated B cell depletion in ABO-incompatible adult living donor liver transplantation
title_sort factors associated with rituximab-mediated b cell depletion in abo-incompatible adult living donor liver transplantation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10583967/
https://www.ncbi.nlm.nih.gov/pubmed/37694598
http://dx.doi.org/10.4285/kjt.23.0031
work_keys_str_mv AT hongsukkyun factorsassociatedwithrituximabmediatedbcelldepletioninaboincompatibleadultlivingdonorlivertransplantation
AT leekwangwoong factorsassociatedwithrituximabmediatedbcelldepletioninaboincompatibleadultlivingdonorlivertransplantation
AT kimjaeyoon factorsassociatedwithrituximabmediatedbcelldepletioninaboincompatibleadultlivingdonorlivertransplantation
AT leejaewon factorsassociatedwithrituximabmediatedbcelldepletioninaboincompatibleadultlivingdonorlivertransplantation
AT kimjiyoung factorsassociatedwithrituximabmediatedbcelldepletioninaboincompatibleadultlivingdonorlivertransplantation
AT choihyunhwa factorsassociatedwithrituximabmediatedbcelldepletioninaboincompatibleadultlivingdonorlivertransplantation
AT hongsuyoung factorsassociatedwithrituximabmediatedbcelldepletioninaboincompatibleadultlivingdonorlivertransplantation
AT leejeongmoo factorsassociatedwithrituximabmediatedbcelldepletioninaboincompatibleadultlivingdonorlivertransplantation
AT choiyoungrok factorsassociatedwithrituximabmediatedbcelldepletioninaboincompatibleadultlivingdonorlivertransplantation
AT yinamjoon factorsassociatedwithrituximabmediatedbcelldepletioninaboincompatibleadultlivingdonorlivertransplantation
AT suhkyungsuk factorsassociatedwithrituximabmediatedbcelldepletioninaboincompatibleadultlivingdonorlivertransplantation