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Kidney transplantation in sensitized recipients; a single center experience

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Title: Kidney transplantation in sensitized recipients; a single center experience
Authors: Kim, Sun Moon, Lee, Chungsik, Lee, Jung Pyo, Kim, Eun Man, Ha, Jongwon, Kim, Sang Joon, Park, Myoung Hee, Ahn, Curie, Kim, Yon Su
Contributors: 김선문, 이정식, 이정표, 김은만, 하종원, 김상준, 박명희, 안규리, 김연수
Publisher Information: Korean Academy of Medical Science
Publication Year: 2009
Collection: Seoul National University: S-Space
Subject Terms: Adult, Antibodies, Monoclonal/pharmacology, Antigens, CD20/biosynthesis, Biopsy, Female, Graft Rejection, Graft Survival, Histocompatibility Testing/methods, Humans, Immunoglobulins/chemistry, Kidney Transplantation/*methods, Male, Middle Aged, Plasmapheresis, Transplantation Conditioning
Description: A successful transplantation, across a positive crossmatch barrier, is one of the most persistent long-standing problems in the field of kidney transplant medicine. The aim of this study was to describe seven consecutive living renal transplantations in recipients with positive crossmatch for donors or positive for donor specific antibodies (DSAs). A preconditioning regimen including plasmapheresis and intravenous immunoglobulin was delivered three times a week until the crossmatch and/or DSAs became negative. Mycophenolate mofetil and tacrolimus were started two days before the plasmapheresis. The protocol was modified to include administration of anti-CD 20 antibody (rituximab, 375 mg/m(2)) from the patient number 3 through the patient number 7. All seven patients achieved negative conversion of the crossmatch or DSAs, and the kidney transplantations were successfully performed in all cases. Acute cellular rejection occurred in two patients, which were subclinical and controlled with high dose steroid treatment. Antibody-mediated rejection occurred in one patient, which was easily reversed with plasmapheresis. All recipients attained normal graft function during the 7-24 months of follow up. Our study suggests that sensitized patients can be transplanted successfully with desensitization pretreatment.
Document Type: article in journal/newspaper
Language: English
Relation: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19194544; https://hdl.handle.net/10371/46136
DOI: 10.3346/jkms.2009.24.S1.S143
Availability: https://hdl.handle.net/10371/46136
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19194544
http://synapse.koreamed.org/Synapse/Data/PDFData/0063JKMS/jkms-24-S143.pdf
https://doi.org/10.3346/jkms.2009.24.S1.S143
Accession Number: edsbas.C1A2849D
Database: BASE
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  Data: Kidney transplantation in sensitized recipients; a single center experience
– Name: Author
  Label: Authors
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  Data: <searchLink fieldCode="AR" term="%22Kim%2C+Sun+Moon%22">Kim, Sun Moon</searchLink><br /><searchLink fieldCode="AR" term="%22Lee%2C+Chungsik%22">Lee, Chungsik</searchLink><br /><searchLink fieldCode="AR" term="%22Lee%2C+Jung+Pyo%22">Lee, Jung Pyo</searchLink><br /><searchLink fieldCode="AR" term="%22Kim%2C+Eun+Man%22">Kim, Eun Man</searchLink><br /><searchLink fieldCode="AR" term="%22Ha%2C+Jongwon%22">Ha, Jongwon</searchLink><br /><searchLink fieldCode="AR" term="%22Kim%2C+Sang+Joon%22">Kim, Sang Joon</searchLink><br /><searchLink fieldCode="AR" term="%22Park%2C+Myoung+Hee%22">Park, Myoung Hee</searchLink><br /><searchLink fieldCode="AR" term="%22Ahn%2C+Curie%22">Ahn, Curie</searchLink><br /><searchLink fieldCode="AR" term="%22Kim%2C+Yon+Su%22">Kim, Yon Su</searchLink>
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  Label: Contributors
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  Data: 김선문<br />이정식<br />이정표<br />김은만<br />하종원<br />김상준<br />박명희<br />안규리<br />김연수
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  Data: Korean Academy of Medical Science
– Name: DatePubCY
  Label: Publication Year
  Group: Date
  Data: 2009
– Name: Subset
  Label: Collection
  Group: HoldingsInfo
  Data: Seoul National University: S-Space
– Name: Subject
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  Data: <searchLink fieldCode="DE" term="%22Adult%22">Adult</searchLink><br /><searchLink fieldCode="DE" term="%22Antibodies%22">Antibodies</searchLink><br /><searchLink fieldCode="DE" term="%22Monoclonal%2Fpharmacology%22">Monoclonal/pharmacology</searchLink><br /><searchLink fieldCode="DE" term="%22Antigens%22">Antigens</searchLink><br /><searchLink fieldCode="DE" term="%22CD20%2Fbiosynthesis%22">CD20/biosynthesis</searchLink><br /><searchLink fieldCode="DE" term="%22Biopsy%22">Biopsy</searchLink><br /><searchLink fieldCode="DE" term="%22Female%22">Female</searchLink><br /><searchLink fieldCode="DE" term="%22Graft+Rejection%22">Graft Rejection</searchLink><br /><searchLink fieldCode="DE" term="%22Graft+Survival%22">Graft Survival</searchLink><br /><searchLink fieldCode="DE" term="%22Histocompatibility+Testing%2Fmethods%22">Histocompatibility Testing/methods</searchLink><br /><searchLink fieldCode="DE" term="%22Humans%22">Humans</searchLink><br /><searchLink fieldCode="DE" term="%22Immunoglobulins%2Fchemistry%22">Immunoglobulins/chemistry</searchLink><br /><searchLink fieldCode="DE" term="%22Kidney+Transplantation%2F*methods%22">Kidney Transplantation/*methods</searchLink><br /><searchLink fieldCode="DE" term="%22Male%22">Male</searchLink><br /><searchLink fieldCode="DE" term="%22Middle+Aged%22">Middle Aged</searchLink><br /><searchLink fieldCode="DE" term="%22Plasmapheresis%22">Plasmapheresis</searchLink><br /><searchLink fieldCode="DE" term="%22Transplantation+Conditioning%22">Transplantation Conditioning</searchLink>
– Name: Abstract
  Label: Description
  Group: Ab
  Data: A successful transplantation, across a positive crossmatch barrier, is one of the most persistent long-standing problems in the field of kidney transplant medicine. The aim of this study was to describe seven consecutive living renal transplantations in recipients with positive crossmatch for donors or positive for donor specific antibodies (DSAs). A preconditioning regimen including plasmapheresis and intravenous immunoglobulin was delivered three times a week until the crossmatch and/or DSAs became negative. Mycophenolate mofetil and tacrolimus were started two days before the plasmapheresis. The protocol was modified to include administration of anti-CD 20 antibody (rituximab, 375 mg/m(2)) from the patient number 3 through the patient number 7. All seven patients achieved negative conversion of the crossmatch or DSAs, and the kidney transplantations were successfully performed in all cases. Acute cellular rejection occurred in two patients, which were subclinical and controlled with high dose steroid treatment. Antibody-mediated rejection occurred in one patient, which was easily reversed with plasmapheresis. All recipients attained normal graft function during the 7-24 months of follow up. Our study suggests that sensitized patients can be transplanted successfully with desensitization pretreatment.
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  Data: article in journal/newspaper
– Name: Language
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  Data: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19194544; https://hdl.handle.net/10371/46136
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.3346/jkms.2009.24.S1.S143
– Name: URL
  Label: Availability
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  Data: https://hdl.handle.net/10371/46136<br />http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19194544<br />http://synapse.koreamed.org/Synapse/Data/PDFData/0063JKMS/jkms-24-S143.pdf<br />https://doi.org/10.3346/jkms.2009.24.S1.S143
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  Data: edsbas.C1A2849D
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