PMID: 15387109Sep 25, 2004Paper

ABO-incompatible renal transplantation at Tokyo Women's Medical University

Clinical Transplants
K TanabeS Teraoka

Abstract

One hundred and forty-one patients with end-stage renal failure underwent ABO-incompatible living kidney transplantation at our institute between January 1989 and December 2001. To remove anti-A and/or anti-B antibodies, the recipients received sessions of double-filtration plasmapheresis and/or sessions of regular plasmapheresis before renal transplantation. Among the initial 53 patients, 1-4 sessions of immunoadsorption were performed before transplantation. Their anti-A immunoglobulin G (IgG)/IgM titers and/or anti-B IgG/IgM titers were reduced to 1:32 or below. Methylprednisolone, cyclosporine or tacrolimus and azathioprine or mycophenolate mofetil were used as basic immunosuppressants. Antilymphocyte globulin and deoxyspergualin were used in the majority of cases performed in the pre-MMF era (1989-1999). Local irradiation of the graft was performed before 2001, but radiation has not been used since MMF was launched in 2001. Splenectomy was done at the time of kidney transplantation in all cases except one. The patient survival rates for ABO-incompatible recipients were 94%, 94%, 88%, and 84% at one-, 5-, 10- and 13-years, respectively. These were not significantly different from those of the concurrent 777 ABO-compatible k...Continue Reading

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