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ABO blood type incompatible kidney transplantation without splenectomy prepared with plasma exchange and rituximab. 2008
T Chikaraishi, and
H Sasaki, and
H Tsutsumi, and
S Miyano, and
R Nakazawa, and
T Nakano, and
K Kitajima, and
H Kudo, and
T Takahashi, and
Y Sato, and
K Kimura
Department of Urology, St. Marianna University, Kawasaki, Kanagawa, Japan. T.chikaraishi@gmail.com
We have designed a protocol for ABO-incompatible kidney transplantations based on preoperative plasmapheresis with a tacrolimus/mycophenolate mofetil/methylprednisolone/basiliximab protocol using low-dose rituximab (200 mg/body) instead of splenectomy to prevent antibody-mediated acute rejection. Eight patients successfully received transplants with this protocol. The titers of anti-A and -B antibodies as well as the number of CD20(+) cells were readily maintained at a low level posttransplantation. There were no side effects. All patients have renal transplant function with a follow-up of 1-34 months.
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