ABO-Incompatible Matching Significantly Enhances Transplant Rates in Kidney Paired Donation

Ferrari, Paolo; Hughes, Peter; Cohney, Solomon; Woodroffe, Claudia; Fidler, S.; D’Orsogna, Lloyd

doi:10.1097/tp.0b013e3182a01311

Cited by 51 publications

(43 citation statements)

References 30 publications

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“…Therefore, participating in a KPD program is an alternative to ABOi Tx for ABOi donor-recipient pairs. However, the successful application of ABOi Tx has excluded an important source of nonsensitized recipients from potential KPD pools [77]. As a consequence of the success of ABOi Tx, it should be possible to accept ABOi, HLA-acceptable donors for patients with low to moderate anti-blood group antibody titers in KPD programs, which should result in a higher transplantation rate in these programs [77].…”

Section: Kidney Paired Donation As An Alternative To Aboi Transplantamentioning

confidence: 99%

Molecular Deciphering of the ABO System as a Basis for Novel Diagnostics and Therapeutics in ABO Incompatible Transplantation

Holgersson¹,

Rydberg²,

Breimer

2013

International Reviews of Immunology

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In recent years ABO incompatible kidney transplantation (KTx) has become a more or less clinical routine procedure with graft and patient survival similar to those of ABO compatible transplants. Antigen-specific immunoadsorption (IA) for anti-A and anti-B antibody removal constitutes in many centers an important part of the treatment protocol. ABO antibody titration by hemagglutination is guiding the treatment; both if the recipient can be transplanted as well as in cases of suspected rejections if antibody removal should be performed. Despite the overall success of ABO incompatible KTx, there is still room for improvements and an extension of the technology to include other solid organs. Based on an increased understanding of the structural complexity and tissue distribution of ABH antigens and the fine epitope specificity of the ABO antibody repertoire, improved IA matrices and ABO antibody diagnostics should be developed. Furthermore, understanding the molecular mechanisms behind accommodation of ABO incompatible renal allografts could make it possible to induce long-term allograft acceptance also in human leukocyte antigen (HLA) sensitized recipients and, perhaps, also make clinical xenotransplantation possible.

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Section: Kidney Paired Donation As An Alternative To Aboi Transplantamentioning

confidence: 99%

Molecular Deciphering of the ABO System as a Basis for Novel Diagnostics and Therapeutics in ABO Incompatible Transplantation

Holgersson¹,

Rydberg²,

Breimer

2013

International Reviews of Immunology

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“…This will minimizes cost, deceases need of immunosuppression and improve long term outcome of ABO incompatible kidney transplantation and increases match rate for the sensitized patients. ABO-incompatible transplantation in the absence of donor specific antibody with low baseline ABO titre ≤ 1:64 has good outcome[27,28]. The cut-off value of high ABO antibody titre may vary as per experience of the transplant unit.…”

Section: Kidney Paired Donation Combined With Abo-incompatible Transpmentioning

confidence: 99%

“…The cut-off value of high ABO antibody titre may vary as per experience of the transplant unit. This strategy is used effectively in the various national kidney paired donation program (Australian > United Kingdom > Canada)[28]. …”

Section: Kidney Paired Donation Combined With Abo-incompatible Transpmentioning

confidence: 99%

Past, present and future of kidney paired donation transplantation in India

Kute¹,

Patel²,

Shah³

et al. 2017

WJT

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One third of healthy willing living kidney donors are rejected due to ABO blood group incompatibility and donor specific antibody. This increases pre-transplant dialysis duration leading to increased morbidity and mortality on the kidney transplantation waiting list. Over the last decade kidney paired donation is most rapidly increased source of living kidney donors. In a kidney transplantation program dominated by living donor kidney transplantation, kidney paired donation is a legal and valid alternative strategy to increase living donor kidney transplantation. This is more useful in countries with limited resources where ABO incompatible kidney transplantation or desensitization protocol is not feasible because of costs/infectious complications and deceased donor kidney transplantation is in initial stages. The matching allocation, ABO blood type imbalance, reciprocity, simultaneity, geography were the limitation for the expansion of kidney paired donation. Here we describe different successful ways to increase living donor kidney transplantation through kidney paired donation. Compatible pairs, domino chain, combination of kidney paired donation with desensitization or ABO incompatible transplantation, international kidney paired donation, non-simultaneous, extended, altruistic donor chain and list exchange are different ways to expand the donor pool. In absence of national kidney paired donation program, a dedicated kidney paired donation team will increase access to living donor kidney transplantation in individual centres with team work. Use of social networking sites to expand donor pool, HLA based national kidney paired donation program will increase quality and quantity of kidney paired donation transplantation. Transplant centres should remove the barriers to a broader implementation of multicentre, national kidney paired donation program to further optimize potential of kidney paired donation to increase transplantation of O group and sensitized patients. This review assists in the development of similar programs in other developing countries.

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“…Some antigenic epitopes in individual A or B antigens are not present in AB antigen and vice versa. Accordingly, using commercial, exclusively A or B erythrocytes to titer anti-AB isohemagglutinins can lead to titer overestimates (5). So, in the four AB to A/B transplantations, the authors report (1), it should have been advisable to titer anti-AB isohemagglutinins using commercial or donorderived AB erythrocytes.…”

Section: To the Editormentioning

confidence: 99%

“…Transplanting low-isoagglutinin titer recipients without any special preparatory regimen would definitively pave the way to safer, cheaper and less invasive ABOi organ transplantations, and will increase solutions in paired exchange pools (5). Nevertheless, until initiation of mycophenolate mofetil 7-14 days before transplantation will be judged unnecessary, application of this ABOi protocol to recipients on deceased donor lists would remain impracticable.…”

Section: To the Editormentioning

confidence: 99%

Potential Hurdles to ABO-Incompatible Living Donor Kidney Transplantation Without Augmented Immunosuppression

Focosi

2015

American Journal of Transplantation

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ABO-Incompatible Matching Significantly Enhances Transplant Rates in Kidney Paired Donation

Abstract: Acceptance of blood group-incompatible donors for patients with low to moderate anti-blood group antibody significantly increases transplant rates for highly sensitized recipients.

Cited by 51 publications

References 30 publications

Molecular Deciphering of the ABO System as a Basis for Novel Diagnostics and Therapeutics in ABO Incompatible Transplantation

Molecular Deciphering of the ABO System as a Basis for Novel Diagnostics and Therapeutics in ABO Incompatible Transplantation

Past, present and future of kidney paired donation transplantation in India

Potential Hurdles to ABO-Incompatible Living Donor Kidney Transplantation Without Augmented Immunosuppression

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