ABO blood type incompatible kidney transplantation without splenectomy prepared with plasma exchange and rituximab.
We have designed a protocol for ABO-incompatible kidney transplantations based on preoperative plasmapheresis with a tacrolimus/mycophenolate mofetil/methylprednisolone/basiliximab protocol using low-dose rituximab (200 mg/body) instead of splenectomy to prevent antibody-mediated acute rejection. Eight patients successfully received transplants with this protocol. The titers of anti-A and -B antibodies as well as the number of CD20(+) cells were readily maintained at a low level posttransplantation. There were no side effects. All patients have renal transplant function with a follow-up of 1-34 months.
Chikaraishi
T
T
Department of Urology, St. Marianna University, Kawasaki, Kanagawa, Japan. T.chikaraishi@gmail.com
Sasaki
H
H
Tsutsumi
H
H
Miyano
S
S
Nakazawa
R
R
Nakano
T
T
Kitajima
K
K
Kudo
H
H
Takahashi
T
T
Sato
Y
Y
Kimura
K
K
D000017:ABO Blood-Group System; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000097:blood / Q000276:immunology; D001787:Blood Group Incompatibility; D003404:Creatinine / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006650:Histocompatibility Testing / Q000379:methods; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007518:Isoantibodies / Q000097:blood; D016030:Kidney Transplantation / Q000276:immunology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009679:Nuclear Family; D010951:Plasma Exchange; D010956:Plasmapheresis; D000069283:Rituximab
D000017:ABO Blood-Group System; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D007518:Isoantibodies; D000069283:Rituximab; D003404:Creatinine