ABO-incompatible transplantation without conventional induction immunosuppression (IL-2RB or depleting agents)
Transplantation across the ABO blood group (ABOI-Tx) has facilitated to increase in donor pool for living donor kidney transplantation. Increased risk of rejection despite augmented immunosuppression has been the concern for many transplant programs in initiating an ABOI-TX program. The benefits of...
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| Published in: | Saudi journal of kidney diseases and transplantation Vol. 31; no. 3; pp. 572 - 581 |
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| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Riyadh, Saudi Arabia
Saudi Center for Organ Transplantation
01-05-2020
Wolters Kluwer India Pvt. Ltd Medknow Publications and Media Pvt. Ltd Medknow Publications & Media Pvt. Ltd Wolters Kluwer Medknow Publications |
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| Online Access: | Get full text |
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| Summary: | Transplantation across the ABO blood group (ABOI-Tx) has facilitated to increase
in donor pool for living donor kidney transplantation. Increased risk of rejection despite
augmented immunosuppression has been the concern for many transplant programs in initiating
an ABOI-TX program. The benefits of induction immunosuppression on long-term graft survival
in immunologically low-risk individuals are still not clear. Increased immunosuppression of
ABOI-Tx recipients before transplantation could provide an opportunity to transplant without
induction with IL2-R blockers or Lymphocyte depleting agents. The aim of our study is to
analyze the outcome of our series of 25 consecutive ABOI-Tx patients who underwent
transplantation without routine thymoglobulin or IL2R-blocker induction. Our study is a
prospective observational study for the first 25 consecutive patients who had undergone ABOI-Tx
from two tertiary care centers in Kerala, India, having the same IS protocol. Anti-A and anti-B
titers ≤1:512 by Gel-method (Biorad) were accepted for desensitization. Patients underwent CDC- crossmatch, Flow-crossmatch, and Luminex-anti-HLA-antibody-screen. Desensitization regimen
included- Rituximab 200 mg on Day-21, Triple IS Prednisolone 10 mg, mycophenolate mofetil
1000 mg, and Tacrolimus 0.06 mg/bodywt from Day-14 and Plasma-exchange (PLEX) 3-4
sessions from day -7 to attain titer of 1:8 before transplantation. Transplantation was done without
induction IS. Twenty-five patients underwent ABOI-Tx from both centers. Twenty recipients
were male. The average age was 34.5 ± 8 years with follow-up of 503 ± 120 days. Eight donors |
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| Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 |
| ISSN: | 1319-2442 2320-3838 |
| DOI: | 10.4103/1319-2442.289443 |