Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Morath, C; Becker, LE; Leo, A; Beimler, J; Klein, K; Seckinger, J; Kihm, LP; Schemmer, P; Macher-Goeppinger, S; Wahrmann, M; Böhmig, GA; Opelz, G; Süsal, C; Zeier, M; Schwenger, V.
ABO-incompatible kidney transplantation enabled by non-antigen-specific immunoadsorption.
Transplantation. 2012; 93(8):827-834
Doi: 10.1097/TP.0b013e31824836ae
Web of Science
PubMed
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FullText_MUG
- Co-authors Med Uni Graz
- Schemmer Peter
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- Abstract:
- ABO-incompatible kidney transplantation performed after desensitization with antigen-specific immunoadsorption (IA) results in good outcomes. However, a unique single-use IA device is required, which creates high costs. From August 2005 to August 2010, 19 patients were desensitized for ABO-incompatible living donor kidney transplantation. Six patients treated with a single-use antigen-specific IA device and 12 patients treated with a reusable non-antigen-specific IA device were analyzed. Six patients who received antigen-specific IA had a median of 5 IA treatments and 12 patients with non-antigen-specific IA had a median of 6 IA treatments preoperatively. Median average titer drop in Coombs technique was 1.2 in antigen-specific IA and 1.7 in non-antigen-specific IA. In two patients with antigen-specific IA and four patients with non-antigen-specific IA, additional plasmapheresis treatments were necessary for recipient desensitization. Despite six treatments with antigen-specific IA and 12 plasmapheresis treatments, one patient with a starting isoagglutinin titer of 1:1024 (Coombs) could not be transplanted. The 18-month graft survival rate for the 17 ABO-incompatible living donor kidney transplants was 100%. One male recipient who was desensitized with antigen-specific IA died 44 months after transplantation from sudden cardiac death with a serum creatinine of 1.2 mg/dL. At last follow-up, a median of 13 months after transplantation, median serum creatinine for 16 patients was 1.5 mg/dL, median glomerular filtration rate as estimated by the modification of diet in renal disease formula 54 mL/min/1.73 m, and median urinary protein-to-creatinine ratio 0.1, with no differences between treatments. A reusable non-antigen-specific IA device allows high number of treatments at reasonable cost, and at the same time might deplete human leukocyte antigen-alloantibodies.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Blood Group Incompatibility - immunology
- Creatinine - blood
- Creatinine - urine
- Female -
- Glomerular Filtration Rate -
- Graft Survival - immunology
- Humans -
- Immunosorbent Techniques -
- Kidney Transplantation - economics
- Kidney Transplantation - immunology
- Male -
- Middle Aged -
- Find related publications in this database (Keywords)
- Kidney transplantation
- ABO-incompatible
- Immunoadsorption
- Rituximab