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Successful Simultaneous Pancreas Kidney Transplantation from Living‐Related Donor Against Positive Cross‐Match
Author(s) -
Sammartino Cinzia,
Pham Thuy,
Panaro Fabrizio,
Bogetti Diego,
Jarzembowski Tomasz,
Sankary Howard,
Morelli Nicola,
Testa Giuliano,
Benedetti Enrico
Publication year - 2004
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1046/j.1600-6135.2003.00296.x
Subject(s) - medicine , plasmapheresis , transplantation , kidney transplantation , kidney , donation , antibody , surgery , urology , immunology , economics , economic growth
A positive pretransplant flow cytometry cross‐match (FC‐XM) allows precise identification of high‐risk recipients vulnerable to hyperacute or accelerated rejection after transplantation. Living donor kidney transplant recipient candidates with positive cross‐match have been successfully treated with a combination of plasmapheresis (therapeutic plasma exchange, TPEX) and intravenous immunoglobulin (IVIG), achieving conversion to negative cross‐match and successful transplant. We report the first successful case of simultaneous pancreas kidney transplant (SPKT) from a living donor (LD) performed against an initially positive FC‐XM, converted to negative using a protocol based on TPEX and IVIG in combination with antiCD20 monoclonal antibody. This strategy of overcoming the cross‐match barriers in living donation may offer a chance of successful transplantation to highly sensitized candidates for SPKT, for whom cadaveric transplant is difficult to achieve.