Use of immunoadsorption columns in ABO-incompatible renal transplantation: A prospective study at a tertiary care center in India

Mukherjee, Debabrata; Hooda, Ashok K; Jairam, Anantharam; Nair, Ranjith K

doi:10.1016/j.mjafi.2019.08.005

Cited by 6 publications

(6 citation statements)

References 23 publications

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“…Table 1 summarizes the baseline characteristics of all ABOiKT procedures performed in this study along with a stratified analysis based on the various ABOiKT protocols used. The median age (interquartile range) of the recipients and donors at the time of ABOiKT was 40 (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)…”

Section: Baseline Demographicsmentioning

confidence: 99%

“…These issues are relevant in emerging countries, such as India, where infections are the primary cause of death. Strikingly, all major reports, including national studies of ABOiKT, have originated from the developed world [16][17][18][19][20][21][22][23][24][25][26] with only a few small case series from India [27][28][29][30][31][32][33][34][35][36] and the developing world. [37][38][39] Here, we present a multicenter study aimed at assessing desensitization protocols, complications, and outcomes of ABOiKT that shares details on the approach and potential of ABOiKT, including plausible future modifications when applied in emerging countries.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Multicenter Retrospective Cohort Study on Management Protocols and Clinical Outcomes After ABO-incompatible Kidney Transplantation in India

Kute,

Pathak,

Ray

et al. 2023

Transplantation

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Background. There is no robust evidence–based data for ABO-incompatible kidney transplantation (ABOiKT) from emerging countries. Methods. Data from 1759 living donor ABOiKT and 33 157 ABO-compatible kidney transplantations (ABOcKT) performed in India between March 5, 2011, and July 2, 2022, were included in this retrospective, multicenter (n = 25) study. The primary outcomes included management protocols, mortality, graft loss, and biopsy-proven acute rejection (BPAR). Results. Protocol included rituximab 100 (232 [13.18%]), 200 (877 [49.85%]), and 500 mg (569 [32.34%]); immunoadsorption (IA) (145 [8.24%]), IVIG (663 [37.69%]), and no induction 200 (11.37%). Mortality, graft loss, and BPAR were reported in 167 (9.49%), 136 (7.73%), and 228 (12.96%) patients, respectively, over a median follow-up of 36.3 mo. In cox proportional hazard model, mortality was higher with IA (hazard ratio [HR]: 2.53 [1.62–3.97]; P < 0.001), BPAR (HR: 1.83 [1.25–2.69]; P = 0.0020), and graft loss (HR: 1.66 [1.05–2.64]; P = 0.0310); improved graft survival was associated with IVIG (HR: 0.44 [0.26–0.72]; P = 0.0010); higher BPAR was reported with conventional tube method (HR: 3.22 [1.9–5.46]; P < 0.0001) and IA use (HR: 2 [1.37–2.92]; P < 0.0001), whereas lower BPAR was reported in the prepandemic era (HR: 0.61 [0.43–0.88]; P = 0.008). Primary outcomes were not associated with rituximab dosing or high preconditioning/presurgery anti-A/anti-B titers. Incidence of overall infection 306 (17.39%), cytomegalovirus 66 (3.75%), and BK virus polyoma virus 20 (1.13%) was low. In unmatched univariate analysis, the outcomes between ABOiKT and ABOcKT were comparable. Conclusions. Our largest multicenter study on ABOiKT provides insights into various protocols and management strategies with results comparable to those of ABOcKT.

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Section: Baseline Demographicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Multicenter Retrospective Cohort Study on Management Protocols and Clinical Outcomes After ABO-incompatible Kidney Transplantation in India

Kute,

Pathak,

Ray

et al. 2023

Transplantation

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“…In Europe, many preconditioning protocols predominantly employ IA techniques using antigen-specific columns. Among these columns are two commercially available types, including the single-use Glycosorb® ABO column (Glycorex AB, Lund, Sweden) and the reusable ABO Adsopak® column [ 11 ]. Additionally, a third column named SECORIM®-ABO has been introduced too [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, a third column named SECORIM®-ABO has been introduced too [ 12 ]. The IA protocol has garnered widespread acceptance and has been effectively executed in numerous reputable institutions globally [ 11 - 13 ].…”

Section: Introductionmentioning

confidence: 99%

Enhancing Success in the ABO-Incompatible Kidney Transplantation: A Case Report

Rana,

Bhalla,

Gupta

et al. 2024

Cureus

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Kidney transplantation is the preferred treatment for end-stage renal disease (ESRD); however, ABO incompatibility (ABOi) poses challenges due to increased graft rejection risk. Desensitization strategies, including immunoadsorption (IA), aim to overcome ABOi barriers. The objective of this case report was to present the initial findings and patient outcomes of ABOi kidney transplantation (KT) using two different brands of IA columns (Glycosorb ® ABO and SECORIM ® -ABO) in reducing isoagglutinin titers to the desired target level. We present a case report of a 51-year-old male with ESRD secondary to diabetic kidney disease who underwent desensitization for ABOi KT, involving rituximab administration followed by IA using Glycosorb ® and Vitrosorb SECORIM ® -ABO columns and plasmapheresis (PP). Glycosorb ® ABO column decreased anti-B titers from an initial level of 1:128/1:128 to 1:64/1:64 (target range ≤1:8); however, the titers rebounded to 1:64 following the fourth session of PP. Subsequent use of Vitrosorb SECORIM ® -ABO column achieved target titers of 1:4, enabling successful transplantation with satisfactory graft function. Monitoring included anti-B IgG/IgM titer levels post IA columns, IA column reuse, kidney function, and adverse events. The IA columns were well tolerated. Desensitization using IA columns effectively reduced anti-B titers, facilitating successful ABOi KT.

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End-stage paediatric heart failure in low- and middle-income countries: challenges in surgical management

Balakrishnan

2024

Indian J Thorac Cardiovasc Surg

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Use of immunoadsorption columns in ABO-incompatible renal transplantation: A prospective study at a tertiary care center in India

Cited by 6 publications

References 23 publications

A Multicenter Retrospective Cohort Study on Management Protocols and Clinical Outcomes After ABO-incompatible Kidney Transplantation in India

A Multicenter Retrospective Cohort Study on Management Protocols and Clinical Outcomes After ABO-incompatible Kidney Transplantation in India

Enhancing Success in the ABO-Incompatible Kidney Transplantation: A Case Report

End-stage paediatric heart failure in low- and middle-income countries: challenges in surgical management

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