ABO-Incompatible Kidney Transplantation: Low Rates of Infectious Complications and Excellent Patient Survival
| Autor: | H. Alhumaidan, I. Ibrahim, D. Broering, H. Aleid, K. Almeshari, T. Ali, I. Alahmadi, E. Hammad, H. Elgamal, Y. Shah, J. Brockmann, M. Hussein |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty medicine.medical_treatment Communicable Diseases ABO Blood-Group System Hypogammaglobulinemia Immunocompromised Host Maintenance therapy Prednisone hemic and lymphatic diseases Internal medicine medicine Humans Kidney transplantation Transplantation Thymoglobulin business.industry Immunosuppression Middle Aged medicine.disease Kidney Transplantation Tacrolimus Blood Group Incompatibility Kidney Failure Chronic Female Surgery Rituximab business Immunosuppressive Agents medicine.drug |
| Zdroj: | Transplantation Proceedings. 51:512-516 |
| ISSN: | 0041-1345 |
| Popis: | Background A significant gap exists between demand and supply of organs for patients with end-stage renal disease. To increase the donor pool, kidney transplantation is performed across ABO- and HLA-incompatible barriers. ABO-incompatible kidney transplant (ABOi-KT) recipients are at increased risk of antibody-mediated rejection, infection, and mortality. Hypogammaglobulinemia secondary to immunosuppression is highly prevalent after solid organ transplantation, and intravenous immunoglobulin (IVIG) has been reported to reduce the risks of infections in various settings. We use high-dose IVIG in ABOi-KT recipients perioperatively. We aimed to determine the rate of infectious complications along with graft and patient survival in our ABOi-KT recipients. Methods We included all adult patients who underwent ABOi-KT from the year 2007 to 2016. Patients received rituximab, plasma exchange, and IVIG (2 g/kg body weight). Thymoglobulin and intravenous methylprednisolone were used as induction treatment. Oral prednisone, mycophenolate mofetil, and tacrolimus were used as maintenance therapy. Results A total of 77 ABOi-KTs were performed, and the recipients were followed up for a median of 1557 days. Two patients were diagnosed as having BK nephropathy. No patients were diagnosed as having pneumocystis infection, cytomegalovirus disease, herpes simplex, varicella zoster, or fungal infection. One-year graft and patient survival was 94.8% and 100%, respectively. Conclusions In our series of ABOi-KTs, we observed a low risk of infectious complications and excellent patient survival. High-dose IVIG might have reduced infections. |
| Databáze: | OpenAIRE |
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