Open AccessRenal transplantation across ABO barrier
Author(s) -
PN Gupta,
Saurabh Pokhariyal,
Shyam Bihari Bansal,
Swati Jain,
Vishal Saxena,
Reetesh Sharma,
Manish Jain,
Pranaw Kumar Jha,
SK Sethi,
Prasun Ghosh,
Arun K. Tewari,
Rajesh Ahlawat,
Vijay Kher
Publication year - 2013
Publication title -
indian journal of nephrology/indian journal of nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.317
H-Index - 24
eISSN - 1998-3662
pISSN - 0971-4065
DOI - 10.4103/0971-4065.111857
Subject(s) - medicine , plasmapheresis , basiliximab , abo blood group system , transplantation , titer , rituximab , dialysis , renal function , antibody titer , antibody , kidney transplantation , creatinine , surgery , urology , gastroenterology , immunology
In India, patients without a compatible blood group donor are usually excluded from renal transplantation. For young patients, it is a difficult therapeutic choice to stay on long-term dialysis. We describe the case of a 19-year-old male patient who had blood group O +ve and had no compatible donor in the family. His mother was B +ve and was willing to donate. The patient had an initial anti-B antibody titer of 1:512 and underwent antibody depletion with plasmapheresis (11 sessions) and intravenous immunoglobulin (IVIG) 100 mg/kg after every plasmapheresis. He also received rituximab 500 mg for 3 days prior to transplant and was induced with basiliximab. At the time of transplant, his anti-B titers were <1:8. Post-operatively, he required four sessions of plasmapheresis and IVIG as his titers rebounded to 1:64. The titers then spontaneously subsided to <1:16 and have stayed at the same level for 6 months post-transplant. The patient continues to have normal renal function with a creatinine of 1.4 mg/dl% and has had no episodes of rejection.