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Titolo:
EXPERIENCE OF ABO-INCOMPATIBLE LIVING KIDNEY-TRANSPLANTATION AFTER DOUBLE FILTRATION PLASMAPHERESIS
Autore:
ISHIKAWA A; ITOH M; USHIYAMA T; SUZUKI K; FUJITA K;
Indirizzi:
HAMAMATSU UNIV,SCH MED,DEPT UROL,3600 HANDA CHO HAMAMATSU SHIZUOKA 43131 JAPAN HAMAMATSU UNIV,SCH MED,DEPT BLOOD TRANSFUS MED HAMAMATSU SHIZUOKA 43131 JAPAN
Titolo Testata:
Clinical transplantation
fascicolo: 2, volume: 12, anno: 1998,
pagine: 80 - 83
SICI:
0902-0063(1998)12:2<80:EOALKA>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
RENAL-TRANSPLANTATION; ANTI-A; IMMUNOADSORPTION; DONORS;
Keywords:
ABO-INCOMPATIBILITY; KIDNEY TRANSPLANTATION; DOUBLE FILTRATION PLASMAPHERESIS; ANTI-A ANTIBODY; ANTI-B ANTIBODY; SALINE TUBE TEST;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
17
Recensione:
Indirizzi per estratti:
Citazione:
A. Ishikawa et al., "EXPERIENCE OF ABO-INCOMPATIBLE LIVING KIDNEY-TRANSPLANTATION AFTER DOUBLE FILTRATION PLASMAPHERESIS", Clinical transplantation, 12(2), 1998, pp. 80-83

Abstract

We achieved success in ABO-incompatible renal allografting after removing anti-A and/or anti-B antibodies from the recipient's plasma usingdouble filtration plasmapheresis (DFPP). We report here the results of our initial 2 cases. Case 1 was a 40-yr-old female whose blood groupwas A +. The donor was her younger brother, a 37-yr-old male, whose blood group was B +. The human lymphocyte antigens (HLAs) were one haplotype identical, and the stimulation index of the mixed lymphocyte culture (MLC-SI) was 34. Case 2 was a 28-yr-old male whose blood group was B +. The donor was his father, a 58-yr-old male, whose blood group was AB +. The HLAs were one-haplotype identical as well, and the MLC-SIwas 71. We carried out 4 sessions of DFPP pre-operatively; i.e. on days -6, -4, -2 and -1. 2.51 of plasma were treated with 500 ml of 4.4% plasma protein fraction in each procedure. The pre-operative target titer of anti-A/B antibody, measured by the saline tube test, was set atless than x 8. We also used 5 kinds of immunosuppressants. Cyclosporine was administered on day -2 beginning with 8 mg/kg/d, and its dose was modified according to the trough level. 500 mg of methylprednisolone were administered intravenously during the operation, and prednisolone was started on day 1 with 60 mg/d and tapered. Azathioprine was started on day -2 with 2 mg/kg/d for 7 d and 1 mg/kg/d thereafter. 5 mg/kg/d of gusperimus was given intravenously from day 0 for 5 d. 30 mg/kg/d of ALG was given intravenously from day 0 for 14 d. Along with these immunosuppressants, 0.1 mg/kg/h of nafamostat mesilate was administered intravenously from day 0 for 3 d, and 4 mg/kg/d of ticlopidine wasgiven orally from day 3. X-Ray irradiation to the renal graft was notdone. Following splenectomy standard renal allografting was performed. In Case 1, the titer of anti-B antibody was reduced from x 16 to x 4. In Case 2, the titer of anti-A antibody was reduced from x 32 to x 4. The post-operative courses of these 2 cases were satisfactory. Although our experience is limited, ABO incompatible kidney transplantationcan safely be performed using DFPP.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/09/20 alle ore 23:10:37