Successful deceased-donor kidney transplantation in crossmatch-positive patients with peritransplant plasma exchange and Rituximab.

Abstract:

:Sensitized patients awaiting renal transplantation have a markedly reduced probability of receiving a crossmatch (XM)-negative renal allograft, and, even if transplanted with a negative complement-dependent cytotoxicity (CDC)-XM, they are at an increased risk of antibody-mediated humoral rejection with early graft loss. We report here for the first time on the effectiveness of a single pretransplant plasma exchange session in rendering a positive complement-dependent cytotoxicity-XM negative and, in combination with anti-CD20 therapy, allowing successful renal transplantation in two sensitized deceased-donor kidney allograft recipients. In a third patient with high donor-specific reactivity, the therapy was unsuccessful. Plasma exchange treatments were continued during the posttransplant period until stable allograft function was achieved. Both patients showed good graft outcome at 27 and 21 months after transplantation with serum creatinine values of 1.60 and 1.25 mg/dL, respectively.

journal_name

Transplantation

journal_title

Transplantation

authors

Beimler JH,Morath C,Schmidt J,Ovens J,Opelz G,Rahmel A,Zeier M,Süsal C

doi

10.1097/TP.0b013e318198a376

subject

Has Abstract

pub_date

2009-03-15 00:00:00

pages

668-71

issue

5

eissn

0041-1337

issn

1534-6080

pii

00007890-200903150-00008

journal_volume

87

pub_type

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