ABO-incompatible kidney transplantation.
BACKGROUND
Kidney transplantation is the optimal treatment for many patients with end-stage renal disease (ESRD). Due to shortage of donor kidneys in Denmark, there is a need to expand the possibilities for donation. At the Odense University Hospital (OUH), we have introduced ABO-incompatible kidney transplantation. We used antigenspecific immunoadsorptions to remove blood group antibodies and anti-CD20 antibody (rituximab) to inhibit the antibody production. The aim of introducing the ABO-incompatible kidney transplantation at the OUH was to increase the rate of living donor kidney transplantation without increasing rejection or mortality rates.


METHODS
Retrospective evaluation. Eleven patients received ABO-incompatible kidney transplantation. The patients were followed for 3-26 months.


RESULTS
One patient had an antibody-mediated rejection, one patient suffered T-cell-mediated rejection, and one patient died of myocardial infarction with a functioning graft on the third post-operative day. Both rejections were treated effectively. Among the patients, the average serum creatinine level was 128 micromol/l.


CONCLUSIONS
The rejection and mortality rates for ABO-incompatible kidney transplantation at the OUH are similar to the results from ABO-compatible kidney transplantations performed at the OUH and at other hospitals.
Department of Nephrology, Odense University Hospital, Denmark. kschousboe@dadlnet.dk
Karoline
K
Schousboe
Kjell
K
Titlestad
Francois
F
Baudier
Lars Ulrich
LU
Hansen
Claus
C
Bistrup
D000017:ABO Blood-Group System; D000328:Adult; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D018951:Antigens, CD20 / Q000276:immunology; D001787:Blood Group Incompatibility / Q000097:blood / Q000276:immunology*; D003404:Creatinine / Q000097:blood; D003718:Denmark; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000097:blood / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D012189:Retrospective Studies; D000069283:Rituximab; D016559:Tacrolimus / Q000627:therapeutic use
D000017:ABO Blood-Group System; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab; D003404:Creatinine; D009173:Mycophenolic Acid; D016559:Tacrolimus