SUCCESSFUL ABO-INCOMPATIBLE KIDNEY TRANSPLANTATION FROM LIVING-RELATED DONOR IN HIGH-SENSITIZED PATIENT
https://doi.org/10.15825/1995-1191-2012-2-63-71
Abstract
This case report describes a patient initially found to have an extremely high anti-B IgM (1:1024) and IgG (1:512) titres.Additionally, patient had previous diseased donor kidney transplantation and high level of anti-HLA panel- reactive antibodies (60%). We focused on immunological monitoring during the pretransplant conditioning and posttransplant period.
About the Authors
A. I. SushkovN. V. Borovkova
N. V. Doronina
Я. Мойсюк
References
1. Organ Donation and Transplantation Activities 2010. 2011; Availablefrom: http://www.transplant-observatory.org/Data%20Reports/Basic%20slides%202010.pdf.
2. Бикбов Б.Т., Томилина Н.А. Состояние заместительной терапии больных с хронической почечной недостаточностью в Российской Федерации в 1998–2009 гг. // Нефрология и диализ. 2011. Т. 13 (3). С. 150–264.
3. Мойсюк Я.Г., Сушков А.И., Пулькова Н.В. и др. Пер-вый отечественный опыт применения иммуноадсорбции при ABO-несовместимой трансплантации почки от живого родственного донора // Вестник трансплантологии и искусственных оргнов. 2011. Т. XIII, No 4. С. 6–18.
4. Шаршаткин А.В. Клинические и хирургические аспекты трансплантации почки от живого родствен- ного донора: Дис. ... докт. мед. наук. 2009. Москва.
5. Akalin E., Pascual M. Sensitization after kidney trans- plantation // Clin. J. Am. Soc. Nephrol. 2006. Vol. 1 (3). P. 433–440.
6. Alexandre G.P, et al. Human ABO-incompatible living donor renal homografts // Neth. J. Med. 1985. Vol. 28 (6). P. 231–234.
7. Breimer M.E. et al. Blood group A and B antigen expres- sion in human kidneys correlated to A1/A2/B, Lewis, and secretor status // Transplantation. 2006. Vol. 82 (4). P. 479–485.
8. Crew R.J., Ratner L.E. ABO-incompatible kidney trans- plantation: current practice and the decade ahead // Curr. Opin Organ Transplant. 2010. Vol. 15 (4). P. 526–530.
9. Delikouras A., Dorling A. Transplant accommodation // Am. J. Transplant. 2003. Vol. 3 (8). P. 917–918.
10. Gloor J.M. et al. A Comparison of splenectomy versus intensive posttransplant antidonor blood group antibody monitoring without splenectomy in ABO-incompatible kidney transplantation // Transplantation. 2005. Vol. 80 (11). P. 1572–1577.
11. Haidinger M. et al. Vienna experience of ABO-incom- patible living-donor kidney transplantation // Wien. Klin. Wochenschr. 2009. Vol. 121 (7–8). P. 247–255.
12. Hourmant M. et al. Frequency and clinical implications of development of donor-specific and non-donor-specific HLA antibodies after kidney transplantation // J. Am. Soc. Nephrol. 2005. Vol. 16 (9). P. 2804–2812.
13. Ichimaru N., Takahara S. Japan’s experience with living- donor kidney transplantation across ABO barriers // Nat. Clin. Pract. Nephrol. 2008. Vol. 4 (12). P. 682–692.
14. Kumlien G. et al. Clinical experience with a new aphere- sis filter that specifically depletes ABO blood group antibodies // Transfusion. 2006. Vol. 46 (9). P. 1568–1575.
15. Lynch R.J., Platt J.L. Accommodation in renal trans- plantation: unanswered questions // Curr. Opin. Organ. Transplant. 2010. Vol. 15 (4). P. 481–485.
16. Oettl T. et al. ABO blood group-incompatible living do- nor kidney transplantation: a prospective, single-centre analysis including serial protocol biopsies // Nephrol. Dial. Transplant. 2009. Vol. 24 (1). P. 298–303.
17. Racusen L.C. et al. Antibody-mediated rejection crite- ria – an addition to the Banff 97 classification of renal allograft rejection // Am. J. Transplant. 2003. Vol. 3 (6). P. 708–714.
18. Sonnenday C.J. et al. Plasmapheresis, CMV hyperim-
19. mune globulin, and anti-CD20 allow ABO-incompatible renal transplantation without splenectomy // Am. J. Transplant. 2004. Vol. 4 (8). P. 1315–1322.
20. Takahashi K. et al. Excellent long-term outcome of ABO-incompatible living donor kidney transplantation in Japan // Am. J. Transplant. 2004. Vol. 4 (7). P. 1089– 1096.
21. Tanabe K. et al. Long-term results of ABO-incompatible living kidney transplantation: a single-center experi- ence // Transplantation. 1998. Vol. 65 (2). P. 224–228
22. Tyden G. et al. Implementation of a Protocol for ABO- incompatible kidney transplantation-a three-center expe- rience with 60 consecutive transplantations // Transplan- tation. 2007. Vol. 83 (9). P. 1153–1155.
23. Tyden G. et al. ABO-incompatible kidney transplanta- tions without splenectomy, using antigen-specific immu- noadsorption and rituximab // Am. J. Transplant. 2005. Vol. 5 (1). P. 145–148.
24. Ushigome H. et al. Findings of graft biopsy specimens within 90 days after ABO blood group incompatible li- ving donor kidney transplantation compared with ABO- identical and non-identical transplantation // Clin. Trans- plant. 2010. Vol. 24. Suppl 22. P. 16–21.
25. Wilpert J. et al. On-demand strategy as an alternative to conventionally scheduled post-transplant immunoadsorp- tions after ABO-incompatible kidney transplantation // Nephrol. Dial. Transplant. 2007. Vol. 22 (10). P. 3048–3051.
26. Wilpert J. et al. ABO-incompatible kidney transplan- tation-proposal of an intensified apheresis strategy for patients with high initial isoagglutinine titers // J. Clin. Apher. 2007. Vol. 22 (6). P. 314–322.
27. Zachary A.A., Leffell M.S. Barriers to successful trans- plantation of the sensitized patient // Expert. Rev. Clin. Immunol. 2010. Vol. 6 (3). P. 449–460.
Review
For citations:
Sushkov A.I., Borovkova N.V., Doronina N.V., SUCCESSFUL ABO-INCOMPATIBLE KIDNEY TRANSPLANTATION FROM LIVING-RELATED DONOR IN HIGH-SENSITIZED PATIENT. Russian Journal of Transplantology and Artificial Organs. 2012;14(2):63-71. (In Russ.) https://doi.org/10.15825/1995-1191-2012-2-63-71