(b) The duration of CD19 B-cell repopulation after rituximab administration compared between the patients with a total response (CR) (= 8) and those with a partial response (PR) (= 10) (participants did not perform screening; = 3). main endpointfor approximately 3 years. There were eight recipients in the case group (38%), and none in the control group reached a complete remission (proteinuria 250 mg/d) at 12 months after treatment. Notably, renal allograft histopathology from patients with rituximab-based regimen showed the less severe endocapillary hypercellularity despite the remaining strong IgA deposition. In conclusion, adjunctive treatment with rituximab potentially demonstrated favorable outcomes for treatment of recurrent severe IgAN post-KT as exhibited by proteinuria reduction and renal allograft function in our cohort. Further in-depth mechanistic studies with the longer follow-up periods are recommended. test and Mann-Whitney test were used to compare the normally distributed variables and skewed data, respectively, of the 2 2 groups. Furthermore, the 2 2 test and Fischer exact test were utilized for the categorical variables and skewed data, respectively. Two-tailed paired Students assessments were also utilized for comparisons before and after each groups treatment. Correlations were calculated using Fishers test. 0.05 was considered statistically significant. Data analysis was performed using the PASW 18.0.0 statistical software package (SPSS Inc., Chicago, IL, USA) and GraphPad Prism 9.1.0 software (GraphPad Software, Inc., La Jolla, CA, USA). 3. Results A total of 134 patients with recurrent IgAN were diagnosed by either a for cause or a surveillance biopsy, but only 64 patients with recurrent IgAN with endocapillary proliferation were included in this study. As such, 21 participants received rituximab as an adjunctive therapy to the standard treatment (case), and 43 Nitenpyram patients were not administered rituximab (control) (Physique 1). Because of the nonavailability of standard treatment for recurrent IgA after KT, rituximab was administered after a thorough discussion between the physicians and the patients about the potential risks and benefits. The demographic characteristics of all participants (recurrent IgAN Nitenpyram post-KT), patients with standard treatment plus rituximab (case) and standard Nitenpyram treatment alone (control) were exhibited in Table 1 Nitenpyram with the similarity between case and Nitenpyram control group. The living related KT was predominantly performed in this cohort. The mean age of patients at transplantation was 54 11 years with the median period from KT to diagnosis of recurrent IgAN being 5.4 years (interquartile range, 3.2C13.5 years). Notably, all recipients experienced at least one episode of proteinuria (UPCR 0.5 mg/g) during the follow-up period, and most of the participants (87%) had a clinical diagnosis CAGL114 of nephrotic syndrome with a mean of maximum proteinuria 3.87 g/d (range, 1.3C9.0 g/d) at the baseline. Although pulse methylprednisolone 1000 mg/day for three days was generally prescribed in patients with cellular crescent IgAN, only three patients (from a total of eight patients) in the rituximab with standard treatment (case group) and five patients (from total of six patients) in the conventional treatment alone (control group) received pulse methylprednisolone during the observation. All the participants received at least ACEIs or ARBs to achieve their blood pressure goals, and there was no preemptive transplantation as well as ABO-incompatible KT in this cohort. All participants have completed the study periods without either mortality or loss to the follow-up. Regarding immunosuppression, only tacrolimus and cyclosporin were adjusted following trough and C2 levels, respectively. There was no dose adjustment of both prednisolone and mycophenolate mofetil during the study periods. Open in a separate windows Physique 1 Flowchart of participants included in the study. FSGS: focal segmental glomerulosclerosis; IgA: immunoglobulin A; and IgAN: immunoglobulin A nephropathy. Table 1 Participants baseline characteristics. = 64)= 21)= 43)(% male)37 (57.8)13 (61.9)24 (55.8)0.65Donor type, (% living donors)59 (92.2)18 (85.7)41 (95.3)0.18Donor age, year39.4 6.138.3 10.641.6 11.20.81Donor gender, (% male)30 (46.9)10 (47.6)20 (46.5)0.93HLA mismatch1.3 0.21.3 0.91.2 1.00.62PRA 30%, (%)14 (21.9)7 (33.3)7 (16.3)0.13Systolic blood pressure (mmHg)130.0 14.8130.6 11.4129.5 12.40.70Diastolic blood pressure (mmHg)75.8 9.477.2 7.873.5 4.50.003Body mass index (kg/m2)23 6.223 2.224.