ABO incompatible kidney transplantation in children.
We have performed 7 pediatric kidney transplantations from living related donors of ABO incompatibility. All patients preoperatively underwent plasmapheresis with or without immunoadsorption to reduce anti-A and/or anti-B antibodies. Immunosuppression initially consisted of methylprednisolone, cyclosporine, azathioprine, antilymphocyte globulin and deoxyspergualin. At transplantation splenectomy was simultaneously performed in all patients. Median followup is 44 months (range 31 to 58). Patient and graft survival rates are 100% to date. There were no uncontrollable vascular rejection episodes, and post-transplant anti-A and/or anti-B antibody titers were always less than 1:32. Transplantation across the ABO blood barrier remains challenging today. However, our small series clearly shows that the preoperative reduction of ABO antibody, simultaneous splenectomy and strict immunosuppressive therapy cause successful long-term results in children.
Yamazaki
Y
Y
Kidney Center, Tokyo Women's Medical College, Japan.
Kawaguchi
H
H
Ito
K
K
Takahashi
K
K
Toma
H
H
Ota
K
K
D000017:ABO Blood-Group System / Q000276:immunology*; D000293:Adolescent; D001787:Blood Group Incompatibility; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology* / Q000401:mortality; D008297:Male; D015996:Survival Rate; D014181:Transplantation Immunology
D000017:ABO Blood-Group System