ABO-Incompatible Kidney Transplantation and Rituximab

• Published in: Transplantation proceedings Vol. 37; no. 8; pp. 3286 - 3287
• Main Authors: Tydén, G., Kumlien, G., Genberg, H., Sandberg, J., Lundgren, T., Fehrman, I.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2005; Elsevier Science
• Subjects: ABO Blood-Group System - immunology; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Murine-Derived; Antigens, CD - blood; Antigens, CD20 - blood; Biological and medical sciences; Blood Group Incompatibility; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Immunologic Factors - therapeutic use; Kidney Transplantation - immunology; Medical sciences; Medicin och hälsovetenskap; Plasmapheresis; Rituximab; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Tissue, organ and graft immunology; Treatment Outcome; Incompatibility; ABO(H)-System; Rituximab; Monoclonal antibody; Homotransplantation; Kidney; Immunomodulator; Medicine; Blood group; Treatment; Urinary system; Surgery; Immunotherapy; Anticytokine; Graft; Kidney transplantation
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2005.09.002

We have designed a protocol for ABO-incompatible kidney transplantations based on antigen-specific immunadsorption rather than plasmapheresis to remove anti-A or anti-B antibodies and with a Prograf/Cellcept/prednisolone protocol using rituximab rather than spenectomy to prevent rebound antibodies. Twelve patients have successfully received transplants with this protocol. The ABO-antibodies were readily removed by the antigen-specific immuoadsorption and maintained at a low-level posttransplantation. There were no side effects. All patients have normal renal transplant function with a follow-up of 1 to 34 months.