title: Desensitization in ABO-Incompatible Kidney Transplantation With Low ABO Iso-Agglutinin Titers.
abstract: BACKGROUND
  In ABO-incompatible (ABOi) kidney transplantation (KT) with low iso-agglutinin (IG) titers (IGT), standard pre-conditioning treatment might be excessive. To try to answer this question, we evaluated the pre-conditioning requirements of a group of ABOi KT with low ABO IGT in our center. Our main objective was to assess desensitization requirements for ABOi KT with low IGT (<16) at Hospital Clinic of Barcelona from 2006 to 2014.
  
  
  METHODS
  A retrospective study of desensitization (rituximab and plasma exchange [PE]) requirements for ABOi KT with IGT <16 was conducted.
  
  
  RESULTS
  One and 5 years after KT, patient survival was 100%. Renal graft survival was 90% at 1 and 5 years after KT. Mean PE performed before KT was 1.7 (standard deviation [SD], 1.703); 50% of the patients did not receive PE after transplantation, 30% received 2 sessions of PE, and 20% received only 1. The average is 0.8 (SD, 0.91).Follow-up IG determinations remained with low titers (≤8/8). No rebounds of titers were observed during the first 4 to 6 months after transplantation.
  
  
  CONCLUSIONS
  Recipients with IGT ≤8 required none or only 1 PE session to reach acceptable titers (titers ≤4) to perform ABOi KT safely. This information is useful to assess the possibility of a minimized desensitization protocol in ABOi KT donors with low titers of IG to reduce adverse effects, reduce cost, and simplify pre-transplant logistics.
authors.affiliation: Department of Nephrology and Renal Transplantation, Hospital Clinic, Barcelona, Catalonia, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Gelpi
authors.affiliation: Apheresis Unit, Department of Hemotherapy and Hemostasis, Hospital Clinic, Barcelona, Catalonia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Cid
authors.affiliation: Apheresis Unit, Department of Hemotherapy and Hemostasis, Hospital Clinic, Barcelona, Catalonia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Lozano
authors.affiliation: Department of Nephrology and Renal Transplantation, Hospital Clinic, Barcelona, Catalonia, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Revuelta
authors.affiliation: Department of Nephrology and Renal Transplantation, Hospital Clinic, Barcelona, Catalonia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Sanchez-Escuredo
authors.affiliation: Department of Nephrology and Renal Transplantation, Hospital Clinic, Barcelona, Catalonia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Blasco
authors.affiliation: Department of Nephrology and Renal Transplantation, Hospital Clinic, Barcelona, Catalonia, Spain.
authors.forename: E
authors.initials: E
authors.lastname: de Souza
authors.affiliation: Department of Nephrology and Renal Transplantation, Hospital Clinic, Barcelona, Catalonia, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Esforzado
authors.affiliation: Department of Nephrology and Renal Transplantation, Hospital Clinic, Barcelona, Catalonia, Spain.
authors.forename: J V
authors.initials: JV
authors.lastname: Torregrosa
authors.affiliation: Department of Nephrology and Renal Transplantation, Hospital Clinic, Barcelona, Catalonia, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Cofán
authors.affiliation: Department of Nephrology and Renal Transplantation, Hospital Clinic, Barcelona, Catalonia, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Ricart
authors.affiliation: Department of Nephrology and Renal Transplantation, Hospital Clinic, Barcelona, Catalonia, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Campistol
authors.affiliation: Department of Nephrology and Renal Transplantation, Hospital Clinic, Barcelona, Catalonia, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Oppenheimer
authors.affiliation: Department of Nephrology and Renal Transplantation, Hospital Clinic, Barcelona, Catalonia, Spain. Electronic address: fritz.diekmann@web.de.
authors.forename: F
authors.initials: F
authors.lastname: Diekmann
mesh_terms: D000017:ABO Blood-Group System; D000328:Adult; D000368:Aged; D000373:Agglutinins / Q000097:blood*; D001787:Blood Group Incompatibility / Q000097:blood* / Q000276:immunology; D003888:Desensitization, Immunologic; D005260:Female; D006085:Graft Survival / Q000276:immunology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000097:blood / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D012189:Retrospective Studies; D000069283:Rituximab / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000017:ABO Blood-Group System; D000373:Agglutinins; D007155:Immunologic Factors; D000069283:Rituximab