The Journal of the Korean Society for Transplantation  2016;30(4):184-189

doi:10.4285/jkstn.2016.30.4.184

A Successful Case of a High Anti A/B Antibody Titer ABO Incompatible Kidney Transplantation Patient Who Received a Kidney from a Hepatitis B Carrier.

Jin Ho LEE 1 ; Han Sae KIM ; Dong Yeol LEE ; Joon Seok OH ; Yong Hun SIN ; Joong Kyung KIM ; Jong Hyun PARK ; Kill HUH ; Jong In PARK

Affiliations

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Keywords

ABO incompatibility; Hepatitis B surface antigen positive donor; Kidney transplantation

Country

Republic of Korea

Language

Korean

Abstract

Kidney transplantation (KTP) lowers the mortality and morbidity of patients with end-stage renal disease. Post-transplantation infection and antibody mediated rejection (AMR) are the most common complications. Hepatitis B surface antigen (HBsAg) positive carrier donors and high anti A/B antibody titer ABO incompatible KTP could lead to recipient hepatitis B virus (HBV) infection and AMR. Here, we report a case of successful KTP in a 41-year-old male with a high titer of ABO incompatible and HBsAg positive donor. He underwent seven rounds of plasmapheresis, low dose intravenous immunoglobulin and rituximab treatment to inhibit antibody production and remove antibodies from the serum, after which he was administered anti-viral agent for HBV prophylaxis. The recipient maintained successful allograft function for 6 months after transplantation; therefore, we report that desensitization and anti-viral treatment achieved successful outcome in a 1:512 anti A/B antibody titer ABO incompatible and hepatitis B carrier donor KTP.