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ABO-incompatible kidney transplantation and rituximab.
G Tydén1, G Kumlien, H Genberg
1Department of Transplantation Surgery, Karolinska University Hospital Huddinge, S-141 86 Stockholm, Sweden. gunnar.tyden@kus.se
Transplantation Proceedings
|November 22, 2005
Summary
This study introduces a new protocol for ABO-incompatible kidney transplants using antigen-specific immunoadsorption and a specific drug regimen. The novel approach successfully removed antibodies and ensured normal kidney function in all twelve patients.
Area of Science:
- Nephrology
- Immunology
- Transplantation Science
Background:
- ABO-incompatible kidney transplantation presents challenges due to pre-formed anti-A or anti-B antibodies.
- Traditional methods like plasmapheresis and splenectomy have limitations in managing these antibodies and preventing rebound.
Purpose of the Study:
- To develop and evaluate a novel protocol for ABO-incompatible kidney transplantation.
- To assess the efficacy and safety of antigen-specific immunoadsorption and a specific immunosuppressive regimen.
Main Methods:
- Developed a protocol utilizing antigen-specific immunoadsorption to remove ABO antibodies.
- Employed a combination of Prograf, Cellcept, and prednisolone with rituximab to prevent antibody rebound.
- Applied this protocol to twelve kidney transplant recipients.
Main Results:
- Antigen-specific immunoadsorption effectively removed ABO antibodies.
- Antibody levels were successfully maintained at low levels post-transplantation.
- All twelve patients exhibited normal renal transplant function with no reported side effects during follow-up (1-34 months).
Conclusions:
- The designed protocol is a safe and effective alternative for ABO-incompatible kidney transplantation.
- Antigen-specific immunoadsorption offers a viable method for antibody removal in this context.
- The immunosuppressive regimen effectively prevents antibody rebound, leading to successful transplant outcomes.