New choices for patients needing kidney transplantation across antibody barriers.
Antibodies in the blood of a kidney transplant recipient can provide a barrier to transplantation, which is additional to the usual possibility of cellular rejection. The antibodies most frequently encountered are ABO (blood group) and human leucocyte antigen (HLA) (tissue-type) antibodies. About 250 living donor transplants each year in the United Kingdom have been stopped because of an antibody barrier. It is now possible to offer a choice of treatment modalities to these people, including exchange transplantation and antibody-incompatible transplantation. It is likely that both schemes will complement each other and both are available in the United Kingdom.
Higgins
Rob
R
Transplant Unit, University Hospitals Coventry and Warwickshire, Coventry, West Midlands, UK. robert.higgins@uhcw.nhs.uk
Hathaway
Mark
M
Lowe
David
D
Zehnder
Daniel
D
Krishnan
Nithya
N
Hamer
Rizwan
R
Briggs
David
D
D000017:ABO Blood-Group System / Q000276:immunology; D001787:Blood Group Incompatibility / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control*; D002755:Choice Behavior; D002985:Clinical Protocols; D046148:Donor Selection / Q000458:organization & administration; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data; D019520:Living Donors / Q000706:statistics & numerical data; D018579:Patient Selection; D010956:Plasmapheresis; D012307:Risk Factors; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
D000017:ABO Blood-Group System; D006680:HLA Antigens