Impact of B Cell Depletion on COVID-19 in Kidney Transplant Recipients
Naohiro Aida,
Taihei Ito,
Kei Kurihara,
Izumi Hiratsuka,
Megumi Shibata,
Atsushi Suzuki,
Midori Hasegawa,
Takashi Kenmochi
Affiliations
Naohiro Aida
Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
Taihei Ito
Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
Kei Kurihara
Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
Izumi Hiratsuka
Department of Endocrinology, Diabetes, and Metabolism, School of Medicine, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
Megumi Shibata
Department of Endocrinology, Diabetes, and Metabolism, School of Medicine, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
Atsushi Suzuki
Department of Endocrinology, Diabetes, and Metabolism, School of Medicine, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
Midori Hasegawa
Department of Nephrology, School of Medicine, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
Takashi Kenmochi
Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
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 (n = 21) and depletion groups (n = 9). Progression rates in the depletion and normal groups were 55.6% and 9.5%, respectively (p = 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; p = 0.021). B cell depletion therapy may have long-term effects and increase the risk of COVID-19 in kidney transplant recipients.
