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Updated: Jun 23, 2026
09:15
Orthotopic Rat Kidney Transplantation: A Novel and Simplified Surgical Approach
Published on: May 7, 2019
ABO incompatible renal transplantation: a paradigm ready for broad implementation.
Robert A Montgomery1, Jayme E Locke, Karen E King
1Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA. rmonty@jhmi.edu
Transplantation
|April 23, 2009
Summary
ABO incompatible kidney transplants can be safe and effective with a simplified immunosuppression protocol. This approach avoids intensive B-cell suppression and achieves excellent graft survival rates comparable to standard transplants.
Area of Science:
- Nephrology
- Transplantation Immunology
Background:
- ABO incompatible (ABOi) kidney transplantation is limited by the need for intense immunosuppression and the risk of antibody-mediated rejection (AMR).
- Previous protocols often involved B-cell depleting therapies like splenectomy or anti-CD20, which carry significant risks.
Purpose of the Study:
- To evaluate the efficacy and safety of a simplified immunosuppression protocol for ABOi kidney transplantation.
- To assess graft survival and AMR rates without long-term B-cell suppression.
Main Methods:
- Retrospective review of 60 consecutive ABOi kidney transplants.
- Implementation of a protocol with brief immunosuppression escalation, omitting splenectomy or anti-CD20.
Main Results:
- 1-, 3-, and 5-year graft survival rates of 98.3%, 92.9%, and 88.7%, respectively.
- No hyperacute rejection or graft loss due to AMR.
- Fewer than 15% experienced mild clinical AMR episodes.
- Median creatinine clearance of 60 mL/min indicates excellent graft function.
Conclusions:
- A simplified immunosuppression regimen for ABOi kidney transplantation is effective and safe.
- Eliminating intensive B-cell suppression does not increase AMR incidence.
- This approach can significantly expand access to kidney transplantation.
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