title: Removal of anti-A/B antibodies for successful kidney transplantation between ABO blood type incompatible couples.
abstract: A growing shortage of cadaveric donors has prompted expansion of the criteria for acceptable living donors. Because of this, ABO-incompatible kidney transplantation has been carried out. To remove anti-A and/or anti-B antibodies, the recipients received one or two sessions of double filtration plasmapheresis (DFPP) and three or four sessions of immunoadsorption prior to transplantation until the anti-A IgG/IgM titers and/or anti-B IgG/IgM titers decreased to 1:16 or less. Our immunosuppressive protocol involved treatment with the drugs methylprednisolone, cyclosporine, azathioprine, anti lymphocyte globulin and deoxyspergualin. The patient survival was 98% at 1 month, 98% at 3 months, 94% at 6 months, and 92% at 1-5 years. Graft survival was 92% at 1 month, 88% at 3 months, 85% at 6 months, 81% at 1 year, and 76% at 5 years. Both DFPP and/or immunoadsorption eliminated anti-ABO antibodies from ABO-incompatible kidney transplant recipients effectively and safely. The results of the ABO-incompatible kidney transplantation were acceptable and not different from those of ABO-compatible cases.
authors.affiliation: Department of Urology, Tokyo Women's Medical College, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tanabe
authors.forename: K
authors.initials: K
authors.lastname: Takahashi
authors.forename: T
authors.initials: T
authors.lastname: Agishi
authors.forename: H
authors.initials: H
authors.lastname: Toma
authors.forename: K
authors.initials: K
authors.lastname: Ota
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000906:Antibodies / Q000097:blood*; D001787:Blood Group Incompatibility; D001788:Blood Grouping and Crossmatching; D006084:Graft Rejection / Q000097:blood / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D007163:Immunosorbent Techniques; D016030:Kidney Transplantation; D006435:Renal Dialysis