ABO-incompatible kidney transplantation and rituximab.
We have designed a protocol for ABO-incompatible kidney transplantations based on antigen-specific immunoadsorption rather than plasmapheresis to remove anti-A or anti-B antibodies and with a Prograf/Cellcept/prednisolone protocol using rituximab rather than splenectomy to prevent rebound antibodies. Twelve patients have successfully received transplants with this protocol. The ABO-antibodies were readily removed by the antigen-specific immunoadsorption and maintained at a low-level posttransplantation. There were no side effects. All patients have normal renal transplant function with a follow-up of 1 to 34 months.
Tydén
G
G
Department of Transplantation Surgery, Karolinska University Hospital Huddinge, S-141 86 Stockholm, Sweden. gunnar.tyden@kus.se
Kumlien
G
G
Genberg
H
H
Sandberg
J
J
Lundgren
T
T
Fehrman
I
I
D000017:ABO Blood-Group System / Q000276:immunology*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D015703:Antigens, CD / Q000097:blood; D018951:Antigens, CD20 / Q000097:blood; D001787:Blood Group Incompatibility; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology*; D010956:Plasmapheresis; D000069283:Rituximab; D016896:Treatment Outcome
D000017:ABO Blood-Group System; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D015703:Antigens, CD; D018951:Antigens, CD20; D007155:Immunologic Factors; D000069283:Rituximab