Combined use of rituximab and plasmapheresis pre‐transplant increases post‐transplant infections in renal transplant recipients with basiliximab induction therapy. Issue 6 (9th September 2013)

• Record Type: Journal Article
• Authors: Chung, B.H.; Yun, J.T.; Ha, S.E.; Kim, J.I.; Moon, I.S.; Choi, B.S.; Park, C.W.; Kim, Y.S.; Yang, C.W.
• Is Part Of: Transplant infectious disease. Volume 15:Issue 6(2013)
• Page Start: 559
• Page End: 568
• Publication Date: 2013-09-09
• Subjects: Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.12135
• Languages: English
• ISSNs: 1398-2273

Abstract

<abstract abstract-type="main" id="tid12135-abs-0001"> <title>Abstract</title> <sec id="tid12135-sec-0001" sec-type="section"> <title>Introduction</title> <p>We investigated the effect of combined use of rituximab (RTX) and plasmapheresis (PP) pre‐transplant on post‐transplant infection.</p> </sec> <sec id="tid12135-sec-0002" sec-type="section"> <title>Methods</title> <p>A total of 196 patients undergoing living‐donor kidney transplantation at Seoul St. Mary's Hospital, all of whom underwent basiliximab induction therapy, were included in the study. They were divided into 3 groups: RTX/PP/intravenous immune globulin (IVIG) (the RPI group; <italic>n</italic> = 53), RTX monotherapy (the RTX group; <italic>n</italic> = 14), and control (the CONT group; <italic>n</italic> = 129). We compared the post‐transplant infections in the 3 groups.</p> </sec> <sec id="tid12135-sec-0003" sec-type="section"> <title>Results</title> <p>The overall prevalence of infection was significantly higher, and the infection‐free survival rate was lower, in the RPI group compared with the RTX or CONT groups (<italic>P</italic> < 0.05). A trend toward more severe bacterial infections was seen in the RPI group compared with the other groups, and fungal infections developed only in the RPI group. After anti‐rejection therapy, a significantly higher rate of infection developed in the RPI group than in the other groups (<italic>P</italic> < 0.05). In addition, the RPI group was an independent risk factor for the development of infection.</p> </sec> <sec id="tid12135-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Our results show that in the setting of basiliximab induction, the use of combined RTX and PP therapy pre‐transplant significantly increases the risk for post‐transplant infection.</p> </sec> </abstract>