ABO-incompatible living donor kidney transplantation without post-transplant therapeutic plasma exchange

Journal of Clinical Apheresis
Julie M Yabu, Magali J Fontaine

Abstract

Blood group incompatibility remains a significant barrier to kidney transplantation. Approximately, one-third of donors are blood group incompatible with their intended recipient. Options for these donor-recipient pairs include blood group incompatible transplantation or kidney paired donation. However, the optimal protocol for blood group incompatible transplantation is unknown. Protocols differ in techniques to remove ABO antibodies, titer targets, and immunosuppression regimens. In addition, the mechanisms of graft accommodation to blood group antigens remain poorly understood. We describe a blood group incompatible protocol using pretransplant therapeutic plasma exchange (TPE), high-dose intravenous immunoglobulin, and rituximab in addition to prednisone, mycophenolate mofetil, and tacrolimus. In this protocol, we do not exclude patients based on a high initial titer and do not implement post-transplant TPE. All 16 patients who underwent this protocol received a living donor transplant with 100% patient and graft survival, and no reported episodes of antibody-mediated rejection to date with a median follow-up of 2.6 years (range 0.75-4.7 years). We conclude that blood group incompatible transplantation can be achieved witho...Continue Reading

References

Feb 13, 1999·Kidney International·L C RacusenY Yamaguchi
Jun 9, 1999·Transplantation·A M AlkhunaiziD J Norman
Apr 17, 2003·Transplantation·James M GloorMark D Stegall
Jun 5, 2003·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Lorraine C RacusenKiril Trpkov
Jul 23, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Christopher J SonnendayRobert A Montgomery
Nov 3, 2004·Transplantation Proceedings·H ShimmuraH Toma
Aug 8, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M HaasR A Montgomery
Sep 14, 2006·Transplantation·James Gloor, Mark Stegall
Aug 30, 2008·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Tobias OettlMichael Dickenmann
Apr 23, 2009·Transplantation·Robert A MontgomeryMark Haas
Oct 17, 2009·Clinical Journal of the American Society of Nephrology : CJASN·Joseph KahwajiAshley A Vo
Jan 12, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·S C JordanA A Vo
Feb 8, 2011·Transplantation·Shohei FuchinoueSatoshi Teraoka
Apr 20, 2011·Archives of Surgery·Gerald S LipshutzPhuong-Thu Pham
Nov 8, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·N KoheiK Tanabe
Feb 1, 2012·Transplantation·John R MontgomeryDorry L Segev
Feb 9, 2012·Transplantation Proceedings·J UchidaT Nakatani
Mar 15, 2012·Transfusion·Magali J FontaineLawrence T Goodnough
Mar 30, 2012·Transplantation·Tatsu TanabeKazunari Tanabe
May 26, 2012·Clinical Journal of the American Society of Nephrology : CJASN·Adnan SharifEdward Kraus
Aug 21, 2012·Transplantation Reviews·Kota Takahashi, Kazuhide Saito

❮ Previous
Next ❯

Citations

Jan 13, 2017·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Rolf BambauerRalf Schiel
Jul 28, 2016·Transplantation·Jelena StojanovicNizam Mamode
Nov 23, 2020·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Samir Saheb, Antonio Gallo

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Group Incompatibility

Blood group incompatibility between donor and recipient has been associated with poor transplant outcomes. Discover the latest research on blood group icompatibility here.