| ABO Incompatible Living Donor Kidney Transplantation with Rituximab and Plasmapheresis: A Single Center Experience |
| Hoon Yu, M.D.1, Yoon Ji Kim, M.D.1, Seog-Woon Kwon, M.D.3, Duck Jong Han, M.D.2, Jae Berm Park, M.D.2, Jung Sik Park, M.D.1, Joo Hee Jung, R.N.4 and Su-Kil Park, M.D.1 |
Department of Internal Medicine1
Department of Surgery2
Department of laboratory3
and Department of Nursing4
Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea |
| 임상연구 : Rituximab와 혈장교환을 사용한 ABO 혈액형 부적합 생체 신장이식: 단일 기관의 경험 |
| 유훈1, 김윤지1, 권석운3, 한덕종2, 박재범2, 박정식1, 정주희4, 박수길1 |
| 울산대학교 의과대학 내과학교실1 , 외과학교실2 , 진단검사학교실3 , 간호부4 |
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| Abstract |
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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. |
| Key Words:
Kidney transplantation, ABO incompatibility |
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