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ABO incompatible kidney transplantation in children
Y Yamazaki1, H Kawaguchi, K Ito
1Kidney Center, Tokyo Women's Medical College, Japan.
The Journal of Urology
|August 1, 1995
Summary
Pediatric kidney transplants across ABO blood types are achievable. Preoperative antibody reduction, splenectomy, and immunosuppression led to 100% patient and graft survival in a small cohort.
Area of Science:
- Nephrology
- Immunology
- Pediatric Surgery
Background:
- ABO-incompatible kidney transplantation in children presents significant challenges due to pre-formed antibodies.
- Overcoming ABO barriers is crucial for expanding donor pools and improving pediatric transplant outcomes.
Purpose of the Study:
- To evaluate the efficacy of a specific protocol for ABO-incompatible pediatric kidney transplantation.
- To assess patient and graft survival rates in this challenging transplant scenario.
Main Methods:
- Seven pediatric patients underwent ABO-incompatible living-related kidney transplantation.
- Preoperative protocols included plasmapheresis and/or immunoadsorption to lower antibody titers.
- Immunosuppression involved a combination of agents, and splenectomy was performed concurrently.
Main Results:
- All 7 patients achieved 100% patient and graft survival at a median follow-up of 44 months.
- Post-transplant antibody titers remained below 1:32, with no uncontrollable vascular rejections.
- Successful transplantation across the ABO barrier was demonstrated in this pediatric cohort.
Conclusions:
- A comprehensive strategy involving preoperative antibody reduction, splenectomy, and robust immunosuppression enables successful ABO-incompatible pediatric kidney transplantation.
- This approach offers a viable option for improving long-term outcomes in children requiring kidney transplants.
- Further research can build upon these findings to refine protocols for ABO-incompatible transplants.