Removal of anti-A/B antibodies for successful kidney transplantation between ABO blood type incompatible couples.
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.
Tanabe
K
K
Department of Urology, Tokyo Women's Medical College, Japan.
Takahashi
K
K
Agishi
T
T
Toma
H
H
Ota
K
K
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