105 216

Cited 0 times in

Role of plasma exchange in ABO-incompatible kidney transplantation

Authors
 Soohun Yoo  ;  Eun Young Lee  ;  Kyu Ha Huh  ;  Myoung Soo Kim  ;  Yu Seun Kim  ;  Hyun Ok Kim 
Citation
 ANNALS OF LABORATORY MEDICINE, Vol.32(4) : 283-288, 2012 
Journal Title
 ANNALS OF LABORATORY MEDICINE 
ISSN
 2234-3806 
Issue Date
2012
MeSH
ABO Blood-Group System/immunology* ; Adult ; Blood Group Incompatibility*/immunology ; Creatinine/blood ; Female ; Glomerular Filtration Rate ; Graft Rejection/therapy ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Isoantibodies/immunology ; Isoantibodies/physiology ; Kidney Transplantation/immunology* ; Male ; Middle Aged ; Plasma Exchange* ; Proteinuria ; Transplantation Conditioning ; Transplantation Immunology
Keywords
ABO blood-group system ; Blood group incompatibility ; Kidney transplantation ; Plasma exchange
Abstract
BACKGROUND: In the past, ABO incompatibility was an absolute contraindication for solid organ transplantation. However, multiple recent trials have suggested strategies for overcoming the reactions between graft antigens and recipient antibodies that cause graft rejection. In this study, we determined the usefulness of plasma exchange (PE) for removing anti-A/B antibodies that cause hyperacute/acute humoral graft rejection in patients undergoing ABO-incompatible kidney transplantation. METHODS: In our study, 12 patients underwent ABO-incompatible kidney transplantation. All recipients received pre-transplantation conditioning by PE or intravenous immunoglobulin (IVIG) administration. After pre-transplantation conditioning, anti-A/B antibody titers were evaluated, and transplantation was performed when the titer was below 1:8. To assess the transplantation outcome, anti-A/B antibody titers, creatinine level, estimated glomerular filtration rate (eGFR), and proteinuria levels were measured. RESULTS: Anti-A/B antibody titers were below 1:8 in all patients at the time of transplantation. eGFR measured on post-transplant day 14 showed that 10 patients had immediate recovery of graft function, while 2 patients had slow recovery of graft function. Short-term outcomes of ABO-incompatible kidney transplantation (measured as creatinine levels) after reducing anti-A/B antibody titers were similar to those of ABO-compatible kidney transplantation. After transplantation, the anti-A/B antibody titers were below 1:8 in 7 patients, but the remaining 5 patients required post-transplantation PE and IVIG treatment to prevent antigen-antibody reactions. CONCLUSIONS: With the increasing demand for kidney donations, interest in overcoming the ABO incompatibility barrier has increased. PE may be an important breakthrough in increasing the availability of kidneys for transplantation. KEYWORDS: ABO blood-group system, Blood group incompatibility, Kidney transplantation, Plasma exchange
Files in This Item:
T201203436.pdf Download
DOI
22779070
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, Yu Seun(김유선) ORCID logo https://orcid.org/0000-0002-5105-1567
Kim, Hyun Ok(김현옥) ORCID logo https://orcid.org/0000-0002-4964-1963
Lee, Eun Young(이은영)
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89514
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse