The European experience.
A new protocol for ABO-incompatible kidney transplantation was introduced in 2001. In this protocol, antigen-specific immunoadsorption to remove existing AB antibodies is used in addition to rituximab to prevent rebound of antibodies and conventional immunosuppression (tacrolimus, mycophenolate mofetil, and prednisolone). This protocol has successively been implemented in many European centers, primarily in Sweden and Germany but also in the UK, Switzerland, the Netherlands, Norway, Denmark, Greece and Spain, and almost 200 ABO-incompatible transplantations have now been performed. In a recent 3-center pooled analysis of 60 consecutive ABO-incompatible living-donor transplantations, there were no graft losses that could be related to the ABO incompatibility and, when compared with ABO-compatible transplantations, no difference in graft or patient survival was found.
Tydén
Gunnar
G
Department of Transplantation Surgery, Karolinska University Hospital, Stockholm, Sweden. gunnar.tyden@karolinska.se
D000017:ABO Blood-Group System; D000327:Adsorption; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D000941:Antigens / Q000737:chemistry; D001781:Blood Component Removal; D001787:Blood Group Incompatibility; D004334:Drug Administration Schedule; D005060:Europe; D006648:Histocompatibility; D006801:Humans; D007074:Immunoglobulin G / Q000737:chemistry; D016756:Immunoglobulins, Intravenous / Q000737:chemistry; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D016030:Kidney Transplantation / Q000379:methods*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000737:chemistry; D000069283:Rituximab
D000017:ABO Blood-Group System; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000941:Antigens; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D000069283:Rituximab; D009173:Mycophenolic Acid