J Korean Soc Transplant.  2011 Mar;25(1):38-42. 10.4285/jkstn.2011.25.1.38.

Case of ABO-Incompatible Living Donor Kidney Transplantation without Blood Products in a Jehovah's Witness

• Choi AS
• Yu SM
• Lee JH
• Oh JS
• Kim SM
• Sin YH
• Kim JK

• KMID: 2202347
• DOI: http://doi.org/10.4285/jkstn.2011.25.1.38

Abstract

ABO-incompatible kidney transplantations have been performed successfully in Korea without splenectomy using plasmapheresis, anti-CD20 monoclonal antibody infusions and other immunosuppressants. However, there is no report of a case of ABO-incompatible kidney transplantation in a Jehovah's Witness. Hence, we report our experience of successful ABO-incompatible kidney transplantation without blood products in a Jehovah's Witness. The recipient was treated with six sessions of plasmapheresis and he received intravenous rituximab before transplantation. Immunosuppressive regimen consisted of tacrolimus, mycophenolate mofetil and steroid. The replacement fluid for plasmapheresis was 5%% albumin solution instead of fresh frozen plasma. We measured the clotting factors before and after plasmapheresis and used cryoprecipitate to prevent bleeding.

Keyword

ABO-incompatible kidney transplantation; Clotting factors; Jehovah's Witness

MeSH Terms

Antibodies, Monoclonal, Murine-Derived
Hemorrhage
Humans
Immunosuppressive Agents
Kidney
Kidney Transplantation
Korea
Living Donors
Mycophenolic Acid
Plasma
Plasmapheresis
Rituximab
Splenectomy
Tacrolimus
Transplants
Wit and Humor as Topic
Antibodies, Monoclonal, Murine-Derived
Immunosuppressive Agents
Mycophenolic Acid
Tacrolimus

Figure

• 

  Fig. 1. Clinical Course: fibrinogen progress on plasmapheresis during pretransplantation period. Abbreviation: PP, pretransplantation plasmapheresis.

Reference

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