Experience with laparoscopic splenectomy for ABO-incompatible living renal transplantation without plasmapheresis.
A 25-year-old male, blood type A, was admitted to our hospital for renal transplantation from his father of AB blood type. Before transplant, we performed laparoscopic splenectomy. The serum anti-B antibody titer fell from 1:8 to 1:2. Therefore, plasmapheresis was not performed. The total ischemic time was 80 minutes. Five immunosuppressive agents, including tacrolimus, mycophenolate mofetil, prednisolone, basiliximab, and deoxyspergualine, were administered in the initial period. On the 47th day, value of cytomegalovirus antibody, which was routinely measured, became positive. Hence, we administered ganciclovir, with a fall in antibody. Sixty-five days after transplant, he was discharged with a serum creatinine of 1.0 mg/dL. We concluded that it was possible to perform ABO-incompatible renal transplantation with no need for plasmapheresis or rituximab.
Hayashi
T
T
Department of Urology, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan. taihaya@ican.zaq.ne.jp
Tahara
H
H
Hara
Y
Y
Ishii
T
T
Uemura
H
H
D000017:ABO Blood-Group System; D000328:Adult; D001787:Blood Group Incompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology*; D010535:Laparoscopy; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D013156:Splenectomy; D016896:Treatment Outcome
D000017:ABO Blood-Group System; D007166:Immunosuppressive Agents