Korean J Nephrol.
2011 Jul;30(4):386-393.
ABO Incompatible Living Donor Kidney Transplantation with Rituximab and Plasmapheresis: A Single Center Experience
- Affiliations
-
- 1Department of Interna Medicine1, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea. skpark@amc.seoul.kr
- 2Department of Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
- 3Department of laboratory, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
- 4Department of Nursing, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
Abstract
- PURPOSE
ABO incompatibility had long been an obstacle in kidney transplantation. However, recent reports showed excellent outcomes. In this study, we evaluated the outcomes of ABO incompatible kidney transplantation with preconditioning protocol using rituximab and plasmapheresis.
METHODS
The recipients who had an ABO-incompatible donor and underwent living donor kidney transplantation were enrolled. Preconditioning protocol was pretransplant single dose rituximab with plasmapheresis at pretransplantation 7-10 days. Immune suppression regimen consisted of tacrolimus, mycophenolate mofetil and steroid. Anti-A or anti-B antibody titer was monitored during preconditioning and post transplantation period.
RESULTS
37 patients underwent living donor ABO incompatible kidney transplantation. Median pre-treatment antibody titer was 1:64 and pre transplant antibody titer after 1-6 times of plasmapheresis was 1:2. Median follow-up duration was 332 days (range 156-681). One episode of acute T cell mediated rejection was observed. Mean serum creatinine at 2 weeks was 1.00+/-0.27 mg/dL and at 24 weeks was 1.21+/-0.37 mg/dL.
CONCLUSION
ABO incompatible kidney transplantation with rituximab and plasmapheresis can be safely performed. It is therefore a valuable option for expanding donor pool and should be actively performed in Korea.
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