Improved outcomes after ABO-incompatible living-donor kidney transplantation after 4 weeks of treatment with mycophenolate mofetil.
Hyperacute humoral rejection of ABO-incompatible kidney transplants limits the application of this procedure. We evaluated the effect of 4-week treatment with mycophenolate mofetil (MMF), a compound that inhibits antibody production by B cells, before ABO-incompatible living-donor kidney transplantation with tacrolimus as the primary immunosuppressant. In contrast with cases without MMF pretreatment, we did not observe any graft loss caused by hyperacute humoral rejection in the 18 patients who received MMF. Overall, the incidence of adverse events was comparable in the MMF-treated and -untreated groups. The administration of MMF 4 weeks before kidney transplant effectively inhibits B-cell function, suggesting a potential role for MMF in the prevention of humoral rejection.
Mannami
Makoto
M
Department of Urology, Uwajima Tokushukai Hospital, 2-6-24 Sumiyoshi, Uwajima 798-0003, Japan. mannami.makoto@uwatoku.org
Mitsuhata
Naoki
N
D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D000368:Aged; D000917:Antibody Formation; D001787:Blood Group Incompatibility; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000517:prevention & control; D006085:Graft Survival / Q000187:drug effects / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D014019:Tissue Donors
D000017:ABO Blood-Group System; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid