Background and objectives Thirty percent of the kidney transplant waiting list has preformed anti-HLA antibodies resulting in prolonged times to transplantation. Mycophenolate mofetil (MMF) and Rituximab (RIT) are two agents with anti-B cell properties that are used in transplantation and have been associated with decreased antibody levels. The goal of this trial was to determine if treatment of sensitized kidney transplant candidates with MMF or RIT would decrease kidney transplant candidate antibody levels. Design, setting, participants and measurements All candidates on the active kidney wait list at the University of Washington with a persistently (>6 months) elevated panel reactive antibody level (PRA) over 50% were screened to receive MMF for 8 months followed by two doses of RIT 1000mg/dose if the PRA had not fallen by 10%. The primary endpoint was the drop in class I and class II PRA. Results Forty-five patients were screened, 30 patients completed at least 4 months of MMF therapy. A decrease in class I (-4.3%) or II (-2.4%) or calculated PRA(CPRA) (-1.6%) was seen with MMF. Likewise a small decrease in class I (-8.0%) or class II (-3,8%) PRA or CPRA (-1.2%) was seen in the 14 patients treated with RIT and MMF. Neither decrease was statistically significant. A moderate decrease in levels of antibody in three patients appeared to contribute to transplantation.
Available at: http://works.bepress.com/kent_koprowicz/21/