First case report of using Ofatumumab in kidney transplantation AB0 incompatible

Nicoletta Mancianti; Giulio Monaci; Fabio Rollo; Paola Buracchi; Andrea Guarnieri; Marina Di Luca; Mauro Martello; Guido Garosi

First case report of using Ofatumumab in kidney transplantation AB0 incompatible

G Ital Nefrol. 2017 Dec 5;34(Nov-Dec):2017-vol6.

[Article in English, Italian]

Authors

Nicoletta Mancianti¹, Giulio Monaci², Fabio Rollo², Paola Buracchi², Andrea Guarnieri², Marina Di Luca³, Mauro Martello³, Guido Garosi²

Affiliations

¹ UOC Nefrologia AO Sant'Andrea, Roma, Dipartimento di Medicina Clinica e Molecolare, Sapienza Università di Roma.
² UOC Nefrologia, Dialisi e Trapianto, Azienda Ospedaliera Universitaria Senese, Siena.
³ UOC Nefrologia, Ospedali Riuniti Marche Nord, Pesaro.

PMID: 29207227

Abstract

Modern methods for desensitization protocol rely heavily on combined apheresis therapy and Rituximab, a chimeric (murine and human) anti-CD20 antibody used in AB0 incompatible kidney transplants. Severe infusion related reactions due to the administration of Rituximab are reported in 10% of patients. These adverse reactions may hinder the completion of the desensitization protocol. Therefore, it's useful to test alternative B cell depleting therapies. Our clinical case focuses on a 41-year-old male who developed an adverse infusion reaction following the administration of Rituximab and was given Ofatumumab as an alternative treatment. Ofatumumab is a fully humanized monoclonal anti-CD20 antibody. As a fully humanized antibody, Ofatumumab may avoid immunogenic reactions. The patient tolerated the administration of the drug showing no signs of adverse side effects and with good clinical efficacy. Our case report suggest that Ofatumumab is a valid alternative B cell depleting agent.

Keywords: AB0 incompatible; Ofatumumab; kidney transplant.

Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

Publication types

Case Reports

MeSH terms

ABO Blood-Group System / immunology*
Aged
Antibodies, Monoclonal / therapeutic use*
Antibodies, Monoclonal, Humanized
Antigens, CD20 / immunology
Basiliximab
Blood Group Incompatibility / drug therapy*
Blood Group Incompatibility / therapy
Drug Hypersensitivity / etiology
Drug Substitution
Female
Histamine Antagonists / therapeutic use
Humans
Kidney Transplantation*
Living Donors
Lymphocyte Depletion / methods*
Male
Middle Aged
Myocardial Ischemia / complications
Nephrosclerosis / complications
Nephrosclerosis / surgery
Nephrosclerosis / therapy
Peritoneal Dialysis
Plasma Exchange
Recombinant Fusion Proteins / therapeutic use
Rituximab / adverse effects
Rituximab / therapeutic use

Substances

ABO Blood-Group System
Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Antigens, CD20
Histamine Antagonists
Recombinant Fusion Proteins
Rituximab
Basiliximab
ofatumumab