Pinpoint targeted immunosuppression: anti‐CD20/MMF desensitization with anti‐CD25 in successful ABO‐incompatible kidney transplantation without splenectomy

Saito, Kazuhide; Nakagawa, Yuki; Suwa, Michihiro; Kumagai, Naoya; Tanikawa, Toshiki; Nishiyama, Tsutomu; Ueno, Mitsuhiro; Gejyo, Fumitake; Nishi, Shinichi; Takahashi, Kota

doi:10.1111/j.1399-3089.2006.00277.x

Cited by 37 publications

(33 citation statements)

References 13 publications

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“…As this case was ABOincompatible and the antibodies against HLA class I and class II were negative in the pre-and postoperative flow PRA, it is highly possible that AMR was caused by the presence of anti-blood group antibodies. In many cases when AMR in ABO-incompatible kidney transplantation occurs, anti-blood group antibody titers increase [8]. In this case, even though the antibodies were absorbed by the graft endothelium and PE was conducted, the anti-A antibody titer remained with the IgG titer !64.…”

Section: Discussionmentioning

confidence: 98%

Clinical Outcome of ABO-Incompatible Living Unrelated Donor Kidney Transplantation

Uchida

Machida²,

Iwai³

et al. 2011

Urol Int

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Background: ABO-incompatible living unrelated donor kidney transplantation is an immunologically high-risk procedure, but few reports have been made on the outcomes of these transplants. Patients and Methods: We analyzed 12 kidney transplants using ABO-incompatible living-unrelated donors performed at our institution between January 1999 and December 2007, focusing on the immunosuppressive protocols, complications and graft survivals. Results: Patient and graft survival rates were 100%. One patient experienced antibody-mediated rejection and intractable acute cellular rejection, one had antibody-mediated rejection and one had acute cellular rejection, but their grafts survived after intensive immunosuppressive treatment. There were no severe complications among the recipients. Conclusions: In ABO-incompatible living unrelated donor kidney transplantation, severe rejections may occur due to ABO incompatibility and poor histocompatibility. Therefore, appropriate desensitization, immunosuppression and recipient care are needed for a successful transplant. Recent significant improvements in outcomes indicate that it has become a viable treatment option, given the lack of available donor organs.

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Section: Discussionmentioning

confidence: 98%

Clinical Outcome of ABO-Incompatible Living Unrelated Donor Kidney Transplantation

Uchida

Machida²,

Iwai³

et al. 2011

Urol Int

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“…To avoid confusion, this review will focus on acute antibody-mediated rejection due to ABO-blood-group-related antigens during the critical period. [5][6][7][8] Reasons for the classifi cation of acute antibody-mediated rejection I am often asked the following questions about ABO-incompatible kidney transplantation: "What types of patients do acute antibody-mediated rejection occur in? Can acute antibody-mediated rejection be predicted?…”

Section: Acute Antibody-mediated Rejectionmentioning

confidence: 99%

“…[1][2][3][4][5][6] group-associated antigens) until the critical period preceding the establishment of accommodation. [5][6][7][8] Cellular rejection…”

Section: Introductionmentioning

confidence: 99%

Recent findings in ABO-incompatible kidney transplantation: classification and therapeutic strategy for acute antibody-mediated rejection due to ABO-blood-group-related antigens during the critical period preceding the establishment of accommodation

Takahashi

2007

Clin Exp Nephrol

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In Japan, ABO-incompatible kidney transplantation has been performed in more than 1000 patients since 1989, and recently accounts for about 18% of all living donor kidney transplants. As for outcomes, since 2001 the 1-year and 3-year graft survival rates have increased to 96% and 94%, respectively, which are similar to those in ABO-compatible transplantation. These improved outcomes are attributed to a clearer understanding of the mechanisms underlying accommodation and acute antibody-mediated rejection, permitting the development of new therapeutic strategies. This review classifies and discusses the clinical significance of acute antibody-mediated rejection due to ABO-blood-group-related antigens during the critical period preceding the establishment of accommodation.

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“…В [8][9][10][11][12][13][14][15][16], фармакологическая иммуносупрессия, антикоагуляция и спленэктомия (98%). Спленэктомия у реципиента проводилась на основании того, что селезенка играет роль в образовании анти-А/В антител.…”

Section: Introductionunclassified

“…Дополнительного послеоперационного удаления антител или введения IVIG не используется [11].В период с 1989 по 2001 год в Японии было выполнено 494 ABO несовместимые трансплантации почки. Для проведения этих операций использовался ряд протоколов подготовки, включающих плазмаферез и различные комбинации иммуносупрессивных препаратов [11,12].…”

Section: Introductionunclassified

ABO incompatible transplantation

et al. 2017

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At present, the problem of the lack of donor organs for transplantation remains. The kidney transplantation from incompatibile donors exists with great caution and distrust. But it could significantly shorten the waiting time for the recipient of the donor organ. Incompatibility of the donor and recipient in the ABO system for decades was considered an absolute contraindication to organ transplantation due to the inevitable development of hyperactive rejection. Against the backdrop of a global body deficiency from cadaver donors, the development of lifelong donation is an alternative resource. According to the centers of transplantation in Japan, 45% of organ transplants are transplants with incompatibility according to the ABO system (nAVO). Successful overcoming of this barrier can help to expand the number of donors and, consequently, donor bodies. In addition, the introduction of ABO-incompatible organs into the practice of transplantation can shorten the waiting period.Key words: ABO-compatibility, kidney, transplantation, anti-AB antibodies.Received: 22-03-2017 Accepted:13-05-2017 UDC: 616-089 ABO-Incompatible Kidney TransplantationVenera Altynova, Nazym Nigmatullina, Saltanat Rakhimzhanova, Nagima Mustapaeva, Samat Isakov. Ана мен бала ұлттық ғылыми орталығы, Астана, Қазақстан ТҰЖЫРЫМДАМА Қазіргі таңда трансплантация жасауға донор мүшерелері жетіспеушілік проблемасы сақталуда. Сәйкестігі жоқ донорлардан бүйректі ауыстырып салуға сенімсіздікпен, жоғары күдікпен қарауда, дегенмен ол реципиенттің донор мүшелерін күту уақытын едәуір азайтуы мүмкін. Жедел трансплантатты қабылдамау реакциясы даму ықтималдылығы жоғары болуына байланысты көптеген жылдар бойы донор мен реципиенттің АВО жүйесі бойынша сәйкессіздігі мүшелер трансплантациясына абсолютты қарама-қарсы көрсеткіш болып табылған. Мәйіттік донор мүшелерінің глобальды жетіспеушілігіне байланысты тірі донрлар альтернативті ресурс ретінде қарастырылуда. Жапония трансплантациялық орталықтарының деректері бойынша АВО жүйесінің сәйкессіздігі кезіндегі трансплантация мүшелер трансплантацияларының 45 пайызын құрайды. Осы кедергіні жетістіктермен басып өткен жағдайда донорлар, сәйкесінше донорлық мүшелер санының артуы ықтимал. Сонымен қатар практикаға АВО-сәйкессіз мүшелер трансплантациясын енгізу трансплантацияны күту кезеңі ұзақтығын қысқартуы мүмкін.Кілтті сөздер: АВО-сәйкессіздік, бүйрек, трансплантация, анти-АВ антидене.ТРАНСПЛАНТАЦИЯ ПРИ АВО НЕСОВМЕСТИМОСТИ Алтынова В.Х., Нигматуллина Н.Б., Рахимжанова С.С., Мустапаева Н.М., Бамыш М.Б., Исаков С.Е Почечный центр, Национальный научный центр материнства и детства.Астана. Казахстан РЕЗЮМЕ В настоящее время остается нерешенной проблема нехватки донорских органов для трансплантации. Сохраняется настороженное, неоднозначное отношение к пересадке несовместимых почек, применение которых могло бы зна-чительно сократить время ожидания реципиентом донорского органа.Несовместимость донора и реципиента по системе АВО десятилетиями считалась абсолютным противопоказанием к трансплантации органов ввиду неизбежного ра...

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Pinpoint targeted immunosuppression: anti‐CD20/MMF desensitization with anti‐CD25 in successful ABO‐incompatible kidney transplantation without splenectomy

Abstract: Anti-CD20/MMF desensitization is safe and allows successful ABO-I kidney transplantation without splenectomy.

Cited by 37 publications

References 13 publications

Clinical Outcome of ABO-Incompatible Living Unrelated Donor Kidney Transplantation

Clinical Outcome of ABO-Incompatible Living Unrelated Donor Kidney Transplantation

Recent findings in ABO-incompatible kidney transplantation: classification and therapeutic strategy for acute antibody-mediated rejection due to ABO-blood-group-related antigens during the critical period preceding the establishment of accommodation

ABO incompatible transplantation

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