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- Title
ABO incompatible high-titer renal transplantation without splenectomy or anti-CD20 treatment.
- Authors
Segev, Dorry L; Simpkins, Christopher E; Warren, Daniel S; King, Karen E; Shirey, R Sue; Maley, Warren R; Melancon, J Keith; Cooper, Matthew; Kozlowski, Tomasz; Montgomery, Robert A
- Abstract
Most successful protocols for renal transplantation across ABO incompatible (ABOi) barriers have utilized splenectomy as part of the pre-conditioning process. We recently described successful ABOi transplantation using anti-CD20 monoclonal antibody in lieu of splenectomy. In the current study, we hypothesized that plasmapheresis (PP) and low dose CMV hyper-immunoglobulin (CMVIg) alone would be sufficient to achieve successful engraftment of ABOi kidneys. We describe four blood type incompatible patients who received live donor renal transplants from A1 (two patients), A2 (one patient), and B (one patient) donors. All patients started with antihuman globulin (AHG) phase titers of 64 or higher and were pre-conditioned with PP/CMVIg but not splenectomy or anti-CD20. All 4 patients underwent successful transplantation and have a mean current serum creatinine of 1.1 (range: 0.9-1.2). There were no episodes of antibody mediated rejection. Rapid allograft accommodation may limit the need for long-term antibody suppression provided by splenectomy or anti-CD20, thereby eliminating the added infectious risk of these modalities and removing another disincentive to ABOi transplantation.
- Publication
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2005, Vol 5, Issue 10, p2570
- ISSN
1600-6135
- Publication type
Journal Article
- DOI
10.1111/j.1600-6143.2005.01031.x