First two ABO-incompatible living renal transplantations using splenectomy, rituximab, plasmapheresis and IVIG as a preconditioning regimen: a single center experience in the Balkans

Xenotransplantation
Ninoslav IvanovskiPerko Kolevski

Abstract

Due to the growing organ shortage in the Balkans and still underdeveloped cadaver transplantation, we started accepting living expanded criteria renal donors including elderly, marginal and unrelated donors (spouses, etc). The ABO-incompatible renal transplantation was initiated last year. The first two successful cases are presented. A 40-yr-old mother (blood group A1B) and a 57-yr-old husband (blood group B) were considered as suitable donors for an 18-yr-old daughter (blood group B) and a 52-yr-old wife (blood group O). Both the recipients had a relatively long dialysis treatment before the surgery. The anti-A1 and anti-B titer of isoaglutinins was 1 : 64 in both the recipients before the procedure. A routine laparoscopic splenectomy was performed 40 and 45 days before the transplantation, without any complications. In the 10 days pre-conditioning period, rituximab was administered in a single dose of 375 mg/m2. At the same time four to five plasmaphereses were performed to reduce the isoaglutinins to below 1 : 4. On the last night before the surgery intravenous immunoglobulin (IVIG) in a dose of 0.5 g/kg/bw was administered. Standard induction and maintenance therapy was introduced (Dacllizumab, CyA-Neoral, MMF and steroids...Continue Reading

References

Mar 17, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Daniel S WarrenRobert A Montgomery
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 2, 2004·Clinical Transplantation·Liise K KaylerLloyd E Ratner
Jan 8, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Gunnar TydénIngela Fehrman

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Citations

Dec 20, 2007·Current Opinion in Nephrology and Hypertension·James M Gloor, Mark D Stegall
Jul 30, 2010·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Bela BalintLjiljana Ignjatovic
Sep 14, 2011·Clinical Transplantation·Ninoslav Ivanovski, Zivko Popov
Jul 16, 2010·Clinical Transplantation·Ninoslav IvanovskiZivko Popov
Mar 15, 2011·Clinical Transplantation·Goce Spasovski

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