Wang Yi, People's Republic of China
the second affiliated hospital, university of south china
Outcomes of ABO incompatible kidney transplantation without antibody remove: Multicenter experiences from China
Wang Yi1,2, Liu Logen2, Shi Bingyi 3, Lin Tao4, Chen Gang5, Liu Hongtao6, Wen Jiqiu7, Changxi Wang8, Luo Zhigang1, Gui Peigeng1, Jiang Hongtao1, Zhou Hao1, Qin Guoqing1, Zhang Yunsheng1, Zou Yizhou9.
1Organ Transplantation Unit/Department of Urology, The Second Affiliated Hospital, University of South China, Hengyang, People's Republic of China; 2Clinical Research Center, The Second Affiliated Hospital, University of South China, Hengyang, People's Republic of China; 3Institute of Organ Transplantation, The 309th Hospital of Chinese People’s Liberation Army, Beijing, People's Republic of China; 4Department of Urology /Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China; 5Institute of Organ Transplantation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, People's Republic of China; 6The Organ Transplantation Center, Anhui Provincial Hospital, Hefei, People's Republic of China; 7National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, People's Republic of China; 8Organ Transplantation Center, The First Affiliated Hospital of Sun Yat-sen University, guangzhou, People's Republic of China; 9Department of Immunology, Xiangya Medical School, Central South University, Changsha, People's Republic of China
Objective: To determine whether low titer of ABO-incompatible (ABOi) kidney transplantation can be performed safely and result in acceptable posttransplantation outcomes.
Materials and Methods: In this study, 13 patients from 4 centers of kidney transplantation in China, with renal failure and an living kidney donor were included，6 patients underwent ABO incompatible transplantation and 7 patients underwent ABO compatible transplantation. Patient and allograft survival; 1-, 3-, and 6-month and 1-year renal function; and incidence of rejection are the Main Outcome Measures
For 6 patients of ABOi the titers of them are 1:1 to 1:4, only 3 of ABOi receptions received anti-CD20 antibody pre-operation, All kidneys were transplanted heterotopically, and all patients received induction immunosuppression followed by a combination of prednisone, mycophenolate mofetil, and tacrolimus. Isoagglutinin titers were monitored.
Results: For 6 patients of ABOi, the donor to recipient transplantation was A to O in 2 cases, B to A in 1, B to O in 1, AB to A in 1 and AB to B in 1. For 7 Patients of ABOc, the donor to recipient transplantation was O to O in 4 cases, A to A in 1, O to B in 1 and A to AB in 1.
All patients with allograft survival was 100%.Mean (SD) creatinine levels, a measure of graft function, in ABOi group were 96.3 (11.2) umol/L at discharge.127.6 (10.4) umol/L at 1 month, 119.0 (13.3) umol/L at 3 months, 92.5(7.3) umol/L at 6 months, and 112 (6.9) umol/L at 1 year; in ABOc group were 87.9 (17.3) umol/L at discharge.118.2 (13.5) umol/L at 1 month, 99.1 (14.0) umol/L at 3 months, 94.5(6.3) umol/L at 6 months, and 103 (7.7) umol/L at 1 year. No statistically significant difference was observed. One episode of cellular rejection occurred in ABOi group.
Conclusions: These short-term results suggest that without antibody remove simplify preconditioning regimen in ABOi kidney transplant compare with the ABOc, it can be obtained the same 1-year patient and graft survival rates in China.
Lectures by Wang Yi
| When | Session | Talk Title | Room |
|---|---|---|---|
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Sat-20 17:00 - 18:30 |
Kidney Posters | Outcomes of ABO Incompatible Kidney Transplantation Without Antibody Remove: Multicenter Experiences from China | Hall 5FG-Level 5 |