Infectious complications in ABO-incompatible living donor kidney transplantation: a single center experience

Tanabe, Kazunari; Takahashi, Kota; Tokumoto, Tadahiko; Ishikawa, Nobuo; Oshima, Tadashi; Kanematsu, Akihiro; Kitani, R; Fuchinoue, S; Yagisawa, T; K, Ota; Teraoka, Satoshi; Agishi, Tetsuzo; Toma, Hiroshi

doi:10.1016/s0041-1345(98)00965-8

Cited by 9 publications

(5 citation statements)

References 3 publications

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“…The 1, 3, and 5-year graft survival for the cohort was 98.3, 92.9, and 88.7%, respectively, with no instances of hyperacute rejection and no grafts lost to AMR. Earlier reports of crossing the blood group barrier generally included splenectomy as part of the treatment regimen [21][22][23][24]. In fact, one report placed specific emphasis on the need for splenectomy, as three recipients who did not undergo splenectomy experienced aggressive antibody-mediated rejection (AMR) and graft loss [25].…”

Section: Crossing Incompatible Barriers-desensitization Strategiesmentioning

confidence: 99%

Incompatible kidney transplantation: lessons from a decade of desensitization and paired kidney exchange

Warren

Montgomery

2010

Immunol Res

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Human leukocyte antigen (HLA) sensitization and ABO incompatibility continue to pose significant barriers to further expansion of live donor renal transplantation. However, the recent development of effective desensitization protocols and creative paired donation strategies demonstrates that the presence of circulating donor HLA-specific antibodies and the use of ABO incompatible organs should no longer be considered contraindications for renal transplantation. It is estimated that as many as 6,000 patients on the kidney transplant waiting list have incompatible living donors and could benefit from these treatments. Furthermore, as our understanding of these treatment modalities has improved, it is now possible to predict whether desensitization, kidney paired donation or a combination of both will provide an individual patient with their best chance for successful renal transplantation.

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Section: Crossing Incompatible Barriers-desensitization Strategiesmentioning

confidence: 99%

Incompatible kidney transplantation: lessons from a decade of desensitization and paired kidney exchange

Warren

Montgomery

2010

Immunol Res

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“…Despite this risk, the vast majority of kidney transplants across the ABO barrier performed during the last two decades have been with splenectomized recipients as listed in Table 3. Tanabe et al . (1998a) studied the infectious complications in 67 patients who underwent ABO‐incompatible living donor renal transplantation between January 1989 and December 1995.…”

Section: Immunosuppressionmentioning

confidence: 99%

ABO‐incompatibility in solid organ transplantation

Rydberg

2001

Transfusion Medicine

208

153

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The most important transplantation antigen system in solid organ transplantation is the ABO histo-blood group system. Crossing the ABO barrier in solid organ transplantation is usually not done except for emergency liver transplantations. Early experiences of crossing the ABO barrier in renal transplantation were very disappointing. In the 1970s, clinical trials were started transplanting kidneys of subgroup A2 into blood group O recipients. The tissues of the A2 subgroup expresses reduced amount of A antigens compared to subgroup A1 and the recipients had no special pretreatment and standard immunosuppression. A number of early graft losses were experienced but the trial also resulted in several long time surviving grafts. A few centres have adapted the concept of A2 to non A kidney transplantations with successful results, when the recipient anti-A titres are low or reduced prior to transplantation. In the early 1980s one group successfully transplanted A1 and B kidneys from living related donors across the ABO-barrier using an immunosuppressive protocol consisting of quadruple drugs and splenectomy and this protocol was adapted by a few other groups. In Japan, where cadaver donors are available in very limited number, the largest number of ABO-incompatible transplantations have been performed. Altogether more than 300 ABO-incompatible kidney transplantations have been performed in more than 40 centres since 1989. ABO-incompatible liver transplantations have been performed mainly in emergency cases and the results have generally been inferior to ABO-compatible grafts. In children below the age of three years, liver transplantations across the ABO-barrier have been quite successful especially with living related donors. Very few ABO-incompatible heart/heart-lung/lung-transplantations have been reported with a few successful cases, but the majority have been failures. Recently a series of ABO-incompatible heart transplants performed in small children have been reported with a high success rate.

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“…The protocol contained several preoperative sessions of plasmapheresis, splenectomy and reinforced immunosuppressive therapy with antilymphocyte globulin and B‐cell‐specific drugs, such as cyclophosphamide or deoxyspergualine [1–5]. Compared with blood group‐compatible transplantations, this procedure was associated with a higher risk of morbidity [8] and showed lower graft survival rates [6]. Especially during the early post‐transplant period, an elevated incidence of acute rejection episodes was found among the recipients of ABO‐incompatible kidneys [6].…”

Section: Discussionmentioning

confidence: 99%

“…In a few institutions, local irradiation of donor graft was added to this regimen [6,7]. These procedures were associated with greater morbidity [8] as well as poorer graft survival [6], when compared with blood group‐compatible transplantations. ABO‐incompatible kidney transplantations showed a higher incidence of acute rejection episodes, especially during the early post‐transplant period [6].…”

Section: Introductionmentioning

confidence: 99%

ABO‐incompatible kidney transplantation of an 8‐yr‐old girl with donor/recipient‐constellation A1B/B

Ahlenstiel¹,

Offner²,

Strehlau³

et al. 2006

Xenotransplantation

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Infectious complications in ABO-incompatible living donor kidney transplantation: a single center experience

Cited by 9 publications

References 3 publications

Incompatible kidney transplantation: lessons from a decade of desensitization and paired kidney exchange

Incompatible kidney transplantation: lessons from a decade of desensitization and paired kidney exchange

ABO‐incompatibility in solid organ transplantation

ABO‐incompatible kidney transplantation of an 8‐yr‐old girl with donor/recipient‐constellation A1B/B

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