Transplantation beyond HLA Barriers: A Case Series
Abstract
Renal transplant is the renal replacement modality of
choice. Even patients, who are highly sensitised, have a
better life expectancy following desensitisation and renal
transplantation than continuing on dialysis. We present three
different patients, with different sensitisation history and all of
them had a positive cross match on a cell based and solid
phase platform, were successfully transplanted after
desensitisation and with a good graft function after a minimum
period of one year.
Full Text:
PDFReferences
Port FK, Wolfe RA, Mauger EA, Berling DP, Jiang K.
Comparison of survival probabilities for dialysis patients vs
cadaveric renal transplant recipients. JAMA 1993;270:
-1343.
Wolfe RA, Ashby VB, Milford EL, et al. Comparison of
mortality in all patients on dialysis, patients on dialysis
awaiting transplantation, and recipients of a first cadaveric
transplant. N Engl J Med 1999;341:1725-1730.
Lee, A., Morgan, C., Conway, P. and Currie, C. (2005).
Characterisation and comparison of health-related quality of
life for patients with renal failure. Current Medical Research
and Opinion, 21(11), pp.1777-1783.
Segev DL, Gentry SE, Warren DS, Reeb B, Montgomery
RA. Kidney paired donation and optimizing the use of live
donor organs. JAMA 2005;293:1883-1890.
Anon, (2017). [online] Available at: 5. United Network for
Organ Sharing home page. (http://www.unos.org.)
Patel R, Terasaki PI. Significance of the positive
crossmatch test in kidney transplantation. N Engl J
Med 1969;280: 735-739.
Williams, G., Deplanque, B., Lower, R. and Hume,
D. (1969). Antibodies and Human Transplant
Rejection. Annals of Surgery, 170(4), 603-616.
Starzl TE, Marchioro TL, Holmes JH, et al. Renal
homografts in patients with major donor-recipient blood group
incompatibilities. Surgery 1964;55:195-200.
Lee PC, Terasaki PI, Takemoto SK, et al. All chronic
rejection failures of kidney transplants were preceded by the
d e v e l o p m e n t o f H L A a n t i b o d -
ies. Transplantation 2002;74:1192-1194.
Higgins RM, Bevan DJ, Carey BS, et al. Prevention of
hyperacute rejection by removal of antibodies to HLA
im m e d i a t e l y b e f o r e r e n a l t r a n s p l a n t a -
tion. Lancet 1996;348:1208-1211.
Stegall, M., Gloor, J., Winters, J., Moore, S. and DeGoey,
S. (2006). A Comparison of Plasmapheresis Versus
High-Dose IVIG Desensitization in Renal Allograft Recipients
with High Levels of Donor Specific Alloantibody. American
Journal of Transplantation, 6(2),346-351.
Higgins R, Hathaway M, Lowe D, et al. Blood levels
of donor-specific human leukocyte antigen antibodies
after renal transplantation: resolution of rejection in the
p r e s e n c e o f c i r c u l a t i n g d o n o r - s p e c i f i c
antibody. Transplantation 2007;84:876-884.
West-Thielke, P., Herren, H., Thielke, J., Oberholzer, J.,
Sankary, H., Raofi, V., Benedetti, E. and Kaplan, B. (2008).
Results of Positive Cross-Match Transplantation in African
American Renal Transplant Recipients. American Journal of
Transplantation, 8(2), pp.348-354.
Vo AA, Lukovsky M, Toyoda M, et al. Rituximab and
intravenous immune globulin for desensitization during renal
transplantation. N Engl J Med 2008;359:242-251.
Montgomery RA, Zachary AA, Ratner LE, et al.
Clinical results from transplanting incompatible live kidney
donor / rec ipient pai rs us ing k idney pai red
donation. JAMA 2005;294:1655-1663.
Montgomery RA, Gentry SE, Marks WH, et al. Domino
paired kidney donation: a strategy to make best use of live
non-directed donation. Lancet 2006;368:419-421.
Gentry SE, Segev DL, Montgomery RA. A comparison of
populations served by kidney paired donation and list paired
donation. Am J Transplant 2005;5:1914-1921.
Marfo, K., Lu, A., Ling, M. and Akalin, E.
(2017). Desensitization Protocols and Their Outcome.
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
An initiative of The Tamil Nadu Dr M.G.R. Medical University