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  • Title: Clinical outcomes of ABO-incompatible kidney transplant with rituximab and double-filtration plasmapheresis.
    Author: Han S, Hwang E, Park S, Park U, Kim H, Cho W.
    Journal: Exp Clin Transplant; 2014 Oct; 12(5):401-4. PubMed ID: 25299367.
    Abstract:
    OBJECTIVES: The best treatment for end-stage renal disease is kidney transplant, but the shortage of donor organs has caused long waiting times for an appropriate organ allograft. The use of ABO-incompatible kidney transplant can be a valuable option to expand the donor pool. The purpose of the present study was to evaluate 13 patients who had successful ABO-incompatible kidney transplant with double-filtration plasmapheresis and rituximab. MATERIALS AND METHODS: From January 2011 to August 2012, there were 13 patients who had ABO-incompatible kidney transplant. Antibody titers were monitored during preconditioning and after transplant. Preconditioning protocol included rituximab, mycophenolate mofetil, tacrolimus, corticosteroids, double-filtration plasmapheresis, and intravenous immunoglobulin. RESULTS: There were no episodes of acute T-cell or antibody-mediated rejection. There were no surgical complications except postoperative bleeding in 1 patient. Mean serum creatinine at 2 weeks after transplant was 71 ± 18 μmol/L (0.8 ± 0.2 mg/dL). At mean follow-up 267 days (range, 1-19 mo), there was no graft loss or patient death. CONCLUSIONS: The ABO-incompatible kidney transplants were successful after the preconditioning protocol that included double-filtration plasmapheresis and rituximab. The use of ABO-incompatible kidney transplant may increase the availability of kidney transplant and avoid or shorten dialysis. Future multicenter studies are justified to develop a standardized preconditioning protocol.
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