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Various desensitization strategies have been attempted to overcome immunologic barriers such as anti-human leukocyte antigen (HLA) donor-specific antibody (DSA) and ABO blood group incompatibility 1,2.

InGroup AB - In All Groups - Measurements


no Antibodies NoAntibodies to 0

ABO-incompatible kidney transplantation (ABOi KT) was introduced to expand the donor pool and minimize shortage of kidneys for transplantatio2,3. An effective desensitization protocol based on plasmapheresis and splenectomy to prevent hyperacute rejection across the ABO antibody barrier was introduced in 19874. Because improved outcomes of ABOi KT were reported in Japan in the early 2000s, the number of ABOi KTs has been increasing worldwideS,6. In addition, a better understanding of

These ABo Heme agglutitins are in the serum of pt. (recipient) as a first step to evaluate these pts. for ABo incompatible kidney transplantation. There are two methods of estimation.

1. Tube method

  1. Gel method

    Gel method is more sensitive and reliable. There are kits

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    Antigen filter or adsopack). transplant is performed.

    2nd dose of Retuximeb is given on day of Transplant if CD 19/ CD 20 counts are still high (morethan 5%)

    Inj. ATG 1mg./kg/ day is given on day 0, day 1and day 2 of transplant.

    Pt. is put on cotrimoxazole and Valgancyclovir as prophylaxis for infection.

    In post op. period Antibody titre are monitored daily and ifit goes > 1:16,pre emptive plasma exchange is done.

    In case pt. requires blood transfusion or fresh frozen plasma. Then either saline washed RBC of Donor blood

    King

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    antibody-mediated rejection in ABO-incompatible renal transplantation. Am J Transplant. 2010;10:1247-1253.

    1. Alexandre GP, Squifflet JP, De Bruyere M, Latinne D, Reding R, Gianello P, Carlier M, Pirson Y. Present experiences in a series of 26 ABO-incompatible living donor renal allografts. Transplant Proc. 1987;19:4538-4542.

    2. Stegall MD, Dean PG, Gloor JM. ABO-incompatible kidney transplantation. Transplantation. 2004;78:635-640.

    3. Tyden G, Kumlien G, Genberg H, Sandberg J, Lundgren T, Fehrman I. ABO incompatible kidney transplantations without splenectomy, using antigen-specific immunoadsorption and rituximab. Am J Transplant. 2005;5: 145-148.