Pneumocystis pneumonia (PCP) is a life-threatening fungal infection that can occur in kidney transplantation (KT) recipients. A growing number of KT recipients are receiving perioperative treatment with rituximab, which is associated with prolonged B-cell depletion and possible risk of PCP occurrence; however, the optimal prophylaxis duration according to rituximab treatment is yet unknown. We compared the occurrence of PCP and the duration of prophylaxis in KT recipients according to rituximab treatment. We retrospectively analyzed 2110 patients who underwent KT between January 2009 and December 2016, who were divided into non-Rituximab group (n = 1588, 75.3%) and rituximab group (n = 522, 24.7%). In the rituximab group, the estimated number needed to treat (NNT) for prophylaxis prolongation from 6 to 12 months was 29.0 with a relative risk reduction of 90.0%. In the non-rituximab group, the estimated NNT value was 133.3 and the relative risk reduction was 66.4%. Rituximab treatment (hazard ratio (HR) = 3.09; P < 0.01) and acute rejection (HR = 2.19; P = 0.03) were significant risk factors for PCP in multivariate analysis. Our results suggest that maintaining PCP prophylaxis for 12 months may be beneficial in KT recipients treated with rituximab for desensitization or acute rejection treatment.

中文翻译：

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根据利妥昔单抗围手术期治疗，肾移植受者肺囊虫性肺炎的发生和预防持续时间。

肺囊虫性肺炎（PCP）是一种威胁生命的真菌感染，可发生在肾脏移植（KT）受者中。越来越多的KT接受围术期接受利妥昔单抗治疗，这与B细胞耗竭时间延长和可能发生PCP的风险有关。然而，根据利妥昔单抗治疗的最佳预防时间尚不清楚。我们根据利妥昔单抗治疗比较了KT接受者中PCP的发生和预防的持续时间。我们回顾性分析了2009年1月至2016年12月接受KT的2110例患者，分为非利妥昔单抗组（n = 1588，75.3％）和利妥昔单抗组（n = 522，24.7％）。在利妥昔单抗组中，预防延长6到12个月所需的治疗（NNT）估计数为29。0，相对风险降低90.0％。在非利妥昔单抗组中，估计的NNT值为133.3，相对风险降低为66.4％。利妥昔单抗治疗（危险比（HR）= 3.09； P <0.01）和急性排斥反应（HR = 2.19； P = 0.03）是多因素分析中PCP的重要危险因素。我们的结果表明，将PCP预防性治疗维持12个月可能对利妥昔单抗脱敏或急性排斥反应治疗的KT受体有益。