Tailored desensitization strategies in ABO blood group antibody incompatible renal transplantation

A. Nicholas R. Barnett, Miriam Manook, Myura Nagendran, Shivakumar Kenchayikoppad, Robert Vaughan, Anthony Dorling, Vassilis G. Hadjianastassiou, Nizam Mamode

Research output: Contribution to journalArticlepeer-review

Abstract

ABO blood group incompatible renal transplantation, using desensitization procedures, is an effective strategy. Efforts have been made to reduce desensitization: these are usually applied to all patients indiscriminately. The Guy's Hospital ABO blood group incompatible desensitization regimen uses a tiered approach, tailoring strategy according to initial antibody titres. Sixty-two ABO blood group incompatible living donor transplant recipients were compared with 167 recipients of blood group compatible living donor renal transplants. There were no statistically significant differences in allograft survival rates at 1 or 3 years post-transplant, rejection in the first year post-transplant or renal function in the first 3 years post-transplant. There was a higher rate of death in ABO blood group incompatible transplant recipients - this could be associated with differences in age and HLA mismatch between the two groups. Four ABO blood group incompatible patients experienced antibody-mediated rejection (no episode was associated with a rise in ABO blood group antibodies). Of the patients who received no desensitization, or rituximab alone, none has experienced antibody mediated rejection or experienced allograft loss. Tailoring the use of desensitization in ABO blood group incompatible renal transplantation according to initial ABO blood group antibody titres led to comparable results to blood group compatible transplantation.

Original languageEnglish
Pages (from-to)187-196
Number of pages10
JournalTransplant International
Volume27
Issue number2
DOIs
Publication statusPublished - Feb 2014

Keywords

  • ABO incompatibility
  • immunoadsorption
  • kidney transplantation
  • monoclonal antibodies
  • plasmapheresis

Fingerprint

Dive into the research topics of 'Tailored desensitization strategies in ABO blood group antibody incompatible renal transplantation'. Together they form a unique fingerprint.

Cite this