An Experience of ABO-incompatible Kidney Transplantation Using Plasmapheresis and Anti-CD20 Monoclonal Antibody.
10.3343/kjlm.2009.29.6.585
- Author:
Hee Won MOON
1
;
Yeo Min YUN
;
Mina HUR
;
Jung Hwan PARK
;
Hae Won LEE
;
Seong Hwan CHANG
;
Ik Jin YUN
Author Information
1. Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea. dearmina@hanmail.net
- Publication Type:Case Report ; English Abstract
- Keywords:
ABO-incompatible kidney transplantation;
Plasmapheresis;
Anti-CD20 antibody;
Intravenous gammaglobulin;
Immunosuppression
- MeSH:
*ABO Blood-Group System;
Adult;
Antibodies, Monoclonal/*therapeutic use;
*Blood Group Incompatibility;
Female;
Humans;
Immunosuppressive Agents/therapeutic use;
*Kidney Transplantation;
Plasmapheresis;
Transplantation Conditioning
- From:The Korean Journal of Laboratory Medicine
2009;29(6):585-588
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Due to an extreme shortage of cadaveric kidneys, many centers in Japan successfully performed ABO-incompatible kidney transplantations using plasmapheresis, splenectomy and immunosuppression. Recently, a protocol including anti-CD20 monoclonal antibody (rituximab) and antigen-selective immunoadsorption has been used for ABO-incompatible transplantation in Europe. In Korea, ABO-incompatible kidney transplantation has been rarely performed. We report an experience of successful ABO-incompatible kidney transplantation using plasmapheresis and rituximab. The patient was a 32-yr-old female suffering from chronic renal failure, and her blood type was O, Rh+. The donor was her husband, and his blood type was B, Rh+. A combination therapy including 5 times of plasmapheresis starting from 10 days before transplantation with 2-day interval, intravenous gammaglobulin, rituximab at 2 weeks before transplantation and potent immunosuppression successfully decreased the titers of anti-A and anti-B antibodies to 1:2 and 1:1, respectively. The kidney transplantation was successful without any sign of hyperacute or acute rejection.
