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ABO-incompatible kidney transplantation using immunoadsorption columns: First experiences in South Africa
1Division of Nephrology and Hypertension, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa. zunaid.barday@uct.ac.za.
Background:
ABO-incompatible kidney transplantation gives patients with chronic kidney disease requiring dialysis and without a blood group-compatible donor an alternative option for a kidney transplant.
Objectives:
To describe our first experiences and outcomes with 3 patients using Glycosorb ABO immunoadsorption (IA) columns in performing ABO-incompatible living-donor kidney transplants. This is the first time this technique has been used in Africa.
Methods:
As per the protocol, patients needed between 1 and 4 sessions of IA and received rituximab ~ one month before transplantation.
Results:
All the patients achieved the target isohaemagglutinin antibody titre of 1:4 pretransplant. Only 1 patient with the highest initial screening titre (1:256) needed IA post-transplant. None of the patients experienced clinical rejection, and all had good graft kidney function at discharge and at the time of writing.
Conclusion:
Glycosorb ABO IA is an effective technique in enabling ABO-incompatible living-donor kidney transplants to be performed successfully in a South African setting.
