THE FIRST RUSSIAN EXPERIENCE OF ABO-INCOMPATIBLE KIDNEY TRANSPLANTATION WITH ANTIGEN-SPECIFIC IMMUNOADSORPTION
https://doi.org/10.15825/1995-1191-2011-4-6-18
Abstract
We report the first Russian experience of successful ABO-incompatible kidney transplantation using anti-CD20 + IA + IvIg pretransplant conditioning protocol and tacrolimus + MMF + steroids as maintenance immunosuppression. IA procedures were performed on reusable columns ABO-Adsopak® (POCARD Ltd. Moscow, Russia). IA treatments following the administration of rituximab efficiently lowered the immunoglobulin M (IgM) and G (IgG) anti-A/B antibodies titers in all patients. The transplantation could be performed in all cases and the kidneys showed primary function. Unfortunately, the biopsy-proven clinical antibody-mediated rejection (AMR) occurred in one case. Episo- de of AMR was successfully reversed. On 6, 4 and 2 months follow-up, serum creatinine levels were 117, 127 and 87 μmol/l, respectively. We consider ABO-incompatible transplantation as a safe and promising procedure in particu- lar cases for those patients having related but ABO-incompatible donors. Given the shortage of donor organs ABO- incompatible living donor kidney transplantation may become a treatment of choice for many patients.
About the Authors
Y. G. Moysyuk
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
A. I. Sushkov
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
N. V. Pulkova
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
V. Y. Abramov
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
A. G. Kupriyanova
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
B. N. Morozov
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
A. K. Porunova
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
N. P. Obraztsova
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
I. Y. Adamova
POCARD Ltd., Moscow
Russian Federation
Russian Federation
S. V. Gautier
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
References
1. Готье C.В., Мойсюк Я.Г., Хомяков С.М. и соавт. Раз- витие органного донорства и трансплантации в Рос- сийской Федерации в 2006–2010 годах. III сообще- ние регистра Российского трансплантологического общества // Вестник трансплантологии и искусствен- ных органов, 2011 (2). С. 6–20.
2. Готье C.В., Цирульникова О.М., Аммосов А.А. и со- авт. Опыт ABO-несовместимых трансплантаций пе- чени // Вестник трансплантологии и искусственных органов, 2011 (2). С. 21–28.
3. Готье С.В., Мойсюк Я.Г., Луцевич О.Э. и соавт. Ла- пароскопическая мануально-ассистированная до- норская нефрэктомия. Первый российский опыт // Вестник трансплантологии и искусственных орга- нов, 2010 (3). С. 6–17.
4. Сушков А.И., Абрамов В.Ю., Мойсюк Я.Г. Роль пред- существующих и de novo антидонорских антител при трансплантации почки // Вестник транспланто- логии и искусственных органов, 2011 (1). С. 84–91.
5. Шаршаткин А.В. Клинические и хирургические аспекты трансплантации почки от живого родствен- ного донора. Дисс. докт. мед. наук. Москва. 2009.
6. Agishi T. et al. Comparative evaluation of immunoads- orption and double filtration plasmapheresis for removal of anti-A or -B antibody in ABO-incompatible kidney transplantation. Japanese Biosynsorb Research Group // Transplant Proc, 1992. Vol. 24 (2). Р. 557–558.
7. Alexander J.W. et al.The late adverse effect of splenectomy on patient survival following cadaveric renal transplantati- on // Transplantation, 1984. Vol. 37 (5). Р. 467–470.
8. Alexandre G.P. et al. Present experiences in a series of 26 ABO-incompatible living donor renal allografts // Trans- plant Proc, 1987. Vol. 19 (6). Р. 4538–4542.
9. Beimler J., Zeier M. ABO-incompatible transplantati- on – a safe way to perform renal transplantation? // Ne- phrol Dial Transplant, 2007. Vol. 22 (1). Р. 25–27.
10. Bensinger W.I. et al. Immunoadsorption for removal of A and B blood-group antibodies // N. Engl. J. Med., 1981. Vol. 304 (3). Р. 160–2.
11. Higgins R. et al. Double filtration plasmapheresis in anti- body-incompatible kidney transplantation // Ther Apher Dial, 2010. Vol. 14 (4). Р. 392–399.
12. Ishida H. et al. Anti-AB titer changes in patients with ABO incompatibility after living related kidney trans- plantations: survey of 101 cases to determine whether splenectomies are necessary for successful transplantati- on // Transplantation, 2000. Vol. 70 (4). Р. 681–685.
13. Johnson P., Glennie M. The mechanisms of action of ri- tuximab in the elimination of tumor cells // Semin Oncol, 2003. Vol. 30 (1 Suppl 2). Р. 3–8.
14. Kaabak M.M. et al. ABO incompatible kidney transplan- tation with campath induction, in esot 2011. 2011: Glas- gow.
15. Kawase T. et al. Short-term results in ABO-incompatible living related kidney transplantation // Transplant Proc, 2002. Vol. 34 (7). Р. 2773.
16. Oriol R. Tissular expression of ABH and Lewis antigens in humans and animals: expected value of different animal models in the study of ABO-incompatible organ trans- plants // Transplant Proc, 1987. Vol. 19 (6). Р. 4416–4420.
17. Pei R. et al. Single human leukocyte antigen flow cy- tometry beads for accurate identification of human leu- kocyte antigen antibody specificities // Transplantation, 2003. Vol. 75 (1). Р. 43–49.
18. Reff M.E. et al. Depletion of B cells in vivo by a chimeric mouse human monoclonal antibody to CD20 // Blood, 1994. Vol. 83 (2). Р. 435–445.
19. Rydberg L. ABO-incompatibility in solid organ trans- plantation // Transfus Med, 2001. Vol. 11 (4). Р. 325–342.
20. Sonnenday C.J. et al. Plasmapheresis, CMV hyperim- mune globulin, and anti-CD20 allow ABO-incompa- tible renal transplantation without splenectomy // Am J.
21. Transplant, 2004. Vol. 4 (8). Р. 1315–1322.
22. Starzl T.E. et al. Splenectomy and Thymectomy in Hu- man Renal Homotransplantation // Proc Soc Exp Biol
23. Med, 1963. Vol. 113. Р. 929–932.
24. Stegall M.D., Dean P.G., Gloor J.M. ABO-incompatible kidney transplantation // Transplantation, 2004. Vol. 78 (5). Р. 635–640.
25. Takahashi K. et al. Excellent long-term outcome of ABO-incompatible living donor kidney transplantation in Japan // Am J. Transplant, 2004. Vol. 4 (7). Р. 1089– 1096.
26. Tanabe K. Double-filtration plasmapheresis // Transplan- tation, 2007. Vol. 84 (12 Suppl). Р. S30–2.
27. 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). Р. 145–148.
28. Tyden G. et al. The Stockholm experience with ABO- incompatible kidney transplantations without splenecto- my // Xenotransplantation, 2006. Vol. 13 (2). Р. 105–107.
29. Warren D.S. et al. Successful renal transplantation ac- ross simultaneous ABO incompatible and positive cross- match barriers // Am J. Transplant., 2004. Vol. 4 (4). Р. 561–568.
Review
For citations:
Moysyuk Y.G., Sushkov A.I., Pulkova N.V., Abramov V.Y., Kupriyanova A.G., Morozov B.N., Porunova A.K., Obraztsova N.P., Adamova I.Y., Gautier S.V. THE FIRST RUSSIAN EXPERIENCE OF ABO-INCOMPATIBLE KIDNEY TRANSPLANTATION WITH ANTIGEN-SPECIFIC IMMUNOADSORPTION. Russian Journal of Transplantology and Artificial Organs. 2011;13(4):6-18. (In Russ.) https://doi.org/10.15825/1995-1191-2011-4-6-18
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