title: AB0 incompatible kidney transplantation using unspecific immunoadsorption.
abstract: BACKGROUND
  A protocol for ABO-incompatible kidney transplantation with antigen specific immunoadsorption, rituximab and conventional immunosuppression has been successfully implemented in many European centers. We report an alternative method for the elimination of isoagglutinins with a number of advantages - large amount of treatable plasma, parallel removal of other rejection-inducing antibodies, long operating life, favorable cost-benefit ratio.
  
  
  METHODS
  We report our first successfully treated case of an ABO-incompatible living donor kidney transplantation using Immunoadsorption with Ig-TheraSorb. We performed 5 sessions preoperatively and one after transplantation. Per treatment session twice the calculated plasma volume (4400 ml in this patient) was treated.
  
  
  RESULTS
  Per treatment session the IgM- isoagglutinin-titers were reduced from 1:16 to 1:1 and the IgG- isoagglutinin-titers from 1:32 to 1:2. There were no side effects and the procedure was well tolerated with good renal function 500 days post transplantation.
  
  
  CONCLUSIONS
  Ig-TheraSorb-Immunoadsorption is an alternative method of elimination of harmful antibodies and it enables successful integration of ABO-incompatible transplantation into regular transplantation programs.
authors: Universität Rostock, Med. Klinik II, Sektion Nephrologie, Germany.
authors: Heiko
authors: H
authors: Hickstein
authors: Universität Rostock, Med. Klinik II, Sektion Nephrologie, Germany. Electronic address: sebastian.koball@medizin.uni-rostock.de.
authors: Sebastian
authors: S
authors: Koball
authors: Universität Rostock, Abt. für Transfusionsmedizin, Germany.
authors: Renate
authors: R
authors: Lehmann
authors: Universität Rostock, Urologische Klinik und Poliklinik, Germany.
authors: Chris
authors: C
authors: Protzel
authors: Universität Rostock, Urologische Klinik und Poliklinik, Germany.
authors: Kathrin
authors: K
authors: Stein
authors: Universität Rostock, Med. Klinik II, Sektion Nephrologie, Germany.
authors: Steffen
authors: S
authors: Mitzner
authors: Universität Rostock, Urologische Klinik und Poliklinik, Germany.
authors: Oliver
authors: O
authors: Hakenberg
mesh_terms: D000017:ABO Blood-Group System; D000328:Adult; D000373:Agglutinins; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D001781:Blood Component Removal / Q000379:methods*; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage; D007163:Immunosorbent Techniques; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D000069283:Rituximab; D014019:Tissue Donors
chemical_list: D000017:ABO Blood-Group System; D000373:Agglutinins; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab
keywords: ABO incompatible transplantation; Immunoadsorption; Isoagglutinin-antibody; Kidney transplantation; Plasmapheresis