title: ABO-incompatible living related donor kidney transplantation: report of two cases.
abstract: The courses of two recipients of ABO-incompatible HLA-identical living related donor kidney transplants are described, the first an A into O and the second a B into A. Both patients were prepared by a month of preoperative azathioprine and a week of plasmapheresis to reduce isohemagglutinin titers in one to 1:2 and in the other to 0 at the time of transplant. Both had early mild steroid-reversible rejections, and the first patient has had an uneventful subsequent course 20 months postgrafting on low-dose cyclosporine and prednisone. The second patient developed a further immunologic event at 1 month that may have been isohemagglutinin mediated or may have been rejection but subsided with OKT3 therapy and plasmapheresis. She lost her graft at 5 months despite normal function during attempts to repair a ureteric fibrosis. Neither patient had donor-specific transfusion or splenectomy. This approach is feasible and should be considered for those patients having related but ABO-incompatible donors.
authors.affiliation: Transplant Service, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: A S
authors.initials: AS
authors.lastname: MacDonald
authors.forename: P
authors.initials: P
authors.lastname: Belitsky
authors.forename: H
authors.initials: H
authors.lastname: Bitter-Seurmann
authors.forename: A
authors.initials: A
authors.lastname: Cohen
authors.forename: M
authors.initials: M
authors.lastname: Gorelick
authors.forename: R
authors.initials: R
authors.lastname: Gupta
mesh_terms: D000017:ABO Blood-Group System / Q000235:genetics / Q000276:immunology*; D000328:Adult; D001787:Blood Group Incompatibility / Q000209:etiology* / Q000235:genetics; D005190:Family; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000096:biosynthesis; D016030:Kidney Transplantation; D008297:Male; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology; D014019:Tissue Donors
chemical_list: D000017:ABO Blood-Group System; D007075:Immunoglobulin M