Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan.
Department of Endocrinology, Diabetes, and Metabolism, School of Medicine, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan.
Viruses. 2023 Jul 7;15(7):1520. doi: 10.3390/v15071520.
Kidney transplant recipients are patients at high risk for coronavirus disease 2019 (COVID-19) due to being on immunosuppressive therapy. B cell depletion therapy, including rituximab, is an important strategy for ABO-incompatible transplants. However, knowledge about the effect of B cell depletion therapy on COVID-19 is lacking. Thirty kidney transplant recipients who developed COVID-19 were included in this study. To examine the impact of B cell depletion therapy, we retrospectively investigated the relationship between the background of the patients and the clinical outcome. Of the 30 patients, 13 received B cell depletion therapy. The median time between transplant and onset of COVID-19 was 6.1 years after transplantation; however, nine cases remained markedly depleted of CD19(+) cells (<4.0%). The patients were assigned to the normal ( = 21) and depletion groups ( = 9). Progression rates in the depletion and normal groups were 55.6% and 9.5%, respectively ( = 0.014). Furthermore, the survival rate was significantly lower in the depletion group (100% in the normal group vs. 66.7% in the depletion group; = 0.021). B cell depletion therapy may have long-term effects and increase the risk of COVID-19 in kidney transplant recipients.
肾移植受者由于接受免疫抑制治疗，因此是 2019 年冠状病毒病（COVID-19）的高危人群。包括利妥昔单抗在内的 B 细胞耗竭疗法是 ABO 不相容移植的重要策略。然而，关于 B 细胞耗竭疗法对 COVID-19 的影响的知识还很缺乏。本研究纳入了 30 名发生 COVID-19 的肾移植受者。为了研究 B 细胞耗竭疗法的影响，我们回顾性调查了患者的背景与临床结局之间的关系。在 30 名患者中，有 13 名接受了 B 细胞耗竭疗法。移植后至 COVID-19 发病的中位时间为移植后 6.1 年；然而，有 9 例患者的 CD19(+)细胞仍明显耗竭（<4.0%）。将患者分为正常组（n = 21）和耗竭组（n = 9）。耗竭组和正常组的进展率分别为 55.6%和 9.5%（= 0.014）。此外，耗竭组的生存率明显较低（正常组为 100%，耗竭组为 66.7%；= 0.021）。B 细胞耗竭疗法可能具有长期影响，并增加肾移植受者 COVID-19 的风险。
