Long-term results of ABO-incompatible kidney transplantation with antigen-specific immunoadsorption and rituximab.
ABO-incompatible (ABOi) kidney transplantation has gained a renewed interest during the past years. In 2001, a protocol for ABOi kidney transplantation based on antigen-specific immunoadsorption and rituximab was introduced at our center. In this study long-term graft function using this protocol was assessed. All ABOi kidney recipients with >1-year follow-up (n=15) were compared with all ABO-compatible (ABOc) living donor kidney recipients maintained on the same basic immunosuppression (n=27). Patient and graft survival as well as rejections and calculated glomerular filtration rate were analyzed. Mean follow-up was 3 years. There was no significant difference in patient and graft survival nor in rejection episodes. Mean glomerular filtration rate (79-83 ml/min) was equivalent at 1, 2, and 3 years in both groups. We conclude that ABOi kidney transplantation using antigen-specific immunoadsorption and rituximab is equivalent to standard ABOc living donor kidney transplantation. ABOi transplantation following this protocol does not have a negative impact on graft function long-term.
Genberg
Helena
H
Department of Transplantation Surgery, Karolinska Institute, Karolinska University Hospital, Huddinge, Sweden. helena.genberg@karolinska.se
Kumlien
Gunilla
G
Wennberg
Lars
L
Tydén
Gunnar
G
D000017:ABO Blood-Group System; D000327:Adsorption; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D001787:Blood Group Incompatibility; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D007164:Immunosorbents / Q000737:chemistry*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000276:immunology; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D000069283:Rituximab; D016896:Treatment Outcome
D000017:ABO Blood-Group System; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007164:Immunosorbents; D007166:Immunosuppressive Agents; D000069283:Rituximab