Buchumschlag

Living donor kidney transplantation in crossmatch-positive patients enabled by peritransplant immunoadsorption and anti-CD20 therapy

Weitere Versionen anzeigen (1)

Living donor kidney transplantation in crossmatch-positive patients is a challenge that requires specific measures. Ten patients with positive crossmatch results (n = 9) or negative crossmatch results but strong donor-specific antibodies (DSA; n = 1) were desensitized using immunoadsorption (IA) and...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Hauptverfasser: Morath, Christian (VerfasserIn) , Zeier, Martin (VerfasserIn) , Süsal, Caner (VerfasserIn) , Beimler, Jörg (VerfasserIn) , Opelz, Gerhard (VerfasserIn) , Scherer, Sabine (VerfasserIn) , Schmidt, Jan (VerfasserIn) , Macher-Göppinger, Stephan (VerfasserIn) , Klein, Katrin (VerfasserIn) , Sommerer, Claudia (VerfasserIn) , Schwenger, Vedat (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 29 February 2012
In: Transplant international
Year: 2012, Jahrgang: 25, Heft: 5, Pages: 506-517
ISSN:1432-2277
DOI:10.1111/j.1432-2277.2012.01447.x
Online-Zugang:Verlag, kostenfrei, Volltext: http://dx.doi.org/10.1111/j.1432-2277.2012.01447.x
Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1432-2277.2012.01447.x
Volltext
Verfasserangaben:Christian Morath; Jörg Beimler; Gerhard Opelz; Sabine Scherer; Jan Schmidt; Stephan Macher-Goeppinger; Katrin Klein; Claudia Sommerer; Vedat Schwenger; Martin Zeier; Caner Süsal
Beschreibung
Zusammenfassung:Living donor kidney transplantation in crossmatch-positive patients is a challenge that requires specific measures. Ten patients with positive crossmatch results (n = 9) or negative crossmatch results but strong donor-specific antibodies (DSA; n = 1) were desensitized using immunoadsorption (IA) and anti-CD20 antibody induction. IA was continued after transplantation and accompanied by HLA antibody monitoring and protocol biopsies. After a median of 10 IA treatments, all patients were desensitized successfully and transplanted. Median levels of mean fluorescence intensity (MFI) of Luminex-DSA before desensitization were 6203 and decreased after desensitization and immediately before transplantation to 891. Patients received a median of seven post-transplant IA treatments. At last visit, after a median follow-up of 19 months, 9 of 10 patients had a functioning allograft and a median Luminex-DSA of 149 MFI; serum creatinine was 1.6 mg/dl, and protein to creatinine ratio 0.1. Reversible acute antibody-mediated rejection was diagnosed in three patients. One allograft was lost after the second post-transplant year in a patient with catastrophic antiphospholipid syndrome. We describe a treatment algorithm for desensitization of living donor kidney transplant recipients that allows the rapid elimination of DSA with a low rate of side effects and results in good graft outcome.
Beschreibung:Gesehen am 07.05.2018
Beschreibung:Online Resource
ISSN:1432-2277
DOI:10.1111/j.1432-2277.2012.01447.x

Ähnliche Einträge