What is rituximab and how does it work? The use of the drug in non-transplant contexts, including lymphoma and rheumatoid arthritis will be described. It has been used in half a million patients; what are the known side effects and difficulties with administration?
What are the results using rituximab in non-sensitised transplant patients? Three ongoing trials and descriptions in blood group incompatible transplantation will be presented.
Highly sensitised patients are difficult to define and often to treat, but interest has increased in recent years. Antibody removal or suppression may involve multimodal therapy, including rituximab, ivIgG, plasma exchange or more radical approaches including liver donation. Few controlled data exist, but studies, particularly from the United States and France have shown good results using a combination of techniques; the results of these studies will be summarised and compared with our own experience.