Changes in anti-HLA antibody titers more than 1 year after desensitization therapy with rituximab in living-donor kidney transplantation.

One hundred sixty-five kidney transplantations were performed from January 2005 to December 2007 at our hospital. Low-dose rituximab was administered to 78 patients as an induction immunosuppressant. Of the 78, 48 were donor-specific anti-HLA antibodies (DSA)-positive, and the changes in the anti-HLA antibody titers could be followed up postoperatively in 35 of these patients. Anti-HLA antibodies belonging to HLA class 1 and HLA class 2 were depleted by 74% and 86%, respectively, and remained depleted for more than 2 years. Although there were no cases of graft loss, one patient suffered from chronic AMR. Thus, we could control DSA for at least a few years after kidney transplantation using rituximab as desensitization therapy.