Outcomes of Pediatric ABO-Incompatible Kidney Transplantations Are Equivalent to ABO-Compatible Controls

Shishido, Seiichiro; Hyodo, Yoji; Aoki, Yujiro; Takasu, J.; Kawamura, Takeshi; Sakai, Ken; Aikawa, Atsushi; Satou, Hiroyuki; Muramatsu, Masaki; Matsui, Zenichi

doi:10.1016/j.transproceed.2011.12.017

Cited by 28 publications

(18 citation statements)

References 7 publications

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“…The majority (56 %) had an increase in anti-ABO titers with an associated increase in serum creatinine (presumed AMR), and one child suffered graft loss due to delayed hyperacute rejection, although the 10-year graft survival was similar to that of ABO-compatible transplantation [21]. These data are consistent with data from adult series [20,22]. The use of antigen-specific column absorption, as opposed to TPE, to reduce ABO antibody titers before transplantation has also been recently reported to be successful in adults and children [23,24].…”

Section: Abo-incompatible Living Donor Renal Donationsupporting

confidence: 80%

“…The largest case series of pediatric patients who received ABO-incompatible renal transplants included 52 Japanese children who were treated with three to four plasma exchange treatments (goal anti-A/B titers of <1:8) prior to transplant. Compared with ABO-compatible recipients during the same time period there were higher rates of AMR among the former, but 10-year outcomes were not significantly different [20]. The same center previously reported 16 pediatric ABO-incompatible living kidney transplants treated with plasma exchange or immunoabsorption prior to transplantation and splenectomy at the time of transplantation.…”

Section: Abo-incompatible Living Donor Renal Donationmentioning

confidence: 75%

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Therapeutic plasma exchange for the treatment of pediatric renal diseases in 2013

Carter

Benador

2013

Pediatr Nephrol

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Therapeutic plasma exchange is an extracorporeal treatment modality that removes systemic circulating pathologic factors or replaces absent plasma components and plays a role in many nephrologic conditions. It presents a number of technical challenges in the pediatric population but has become an increasingly common practice in pediatric nephrology over the past several decades. While prospective evidence is often lacking, our increased understanding of the molecular pathogenesis underlying many pediatric renal diseases provides sound reasoning for the use of plasma exchange in treating these conditions. This review will present the currently accepted indications for plasma exchange in children, the technical aspects of the procedure and its potential complications.

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Section: Abo-incompatible Living Donor Renal Donationsupporting

confidence: 80%

Section: Abo-incompatible Living Donor Renal Donationmentioning

confidence: 75%

Therapeutic plasma exchange for the treatment of pediatric renal diseases in 2013

Carter

Benador

2013

Pediatr Nephrol

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“…In older children, antibody removal using, for example, plasma exchange and rituximab, can be utilized to decrease blood group antibody levels to acceptable levels (aiming for a dilution ratio of 1:8) (5). In a series of 52 consecutive kidney transplants, Shishido et al reported no differences in glomerular filtration rates (GFRs) or patient and allograft survival rates compared with ABO-compatible transplants (6). The levels of blood group antibody titers remained low after transplantation, which suggests a degree of accommodation towards blood group glycoproteins.…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes of children after solid organ transplantation

Kim

Marks

2014

Clinics

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Solid organ transplantation has transformed the lives of many children and adults by providing treatment for patients with organ failure who would have otherwise succumbed to their disease. The first successful transplant in 1954 was a kidney transplant between identical twins, which circumvented the problem of rejection from MHC incompatibility. Further progress in solid organ transplantation was enabled by the discovery of immunosuppressive agents such as corticosteroids and azathioprine in the 1950s and ciclosporin in 1970. Today, solid organ transplantation is a conventional treatment with improved patient and allograft survival rates. However, the challenge that lies ahead is to extend allograft survival time while simultaneously reducing the side effects of immunosuppression. This is particularly important for children who have irreversible organ failure and may require multiple transplants. Pediatric transplant teams also need to improve patient quality of life at a time of physical, emotional and psychosocial development. This review will elaborate on the long-term outcomes of children after kidney, liver, heart, lung and intestinal transplantation. As mortality rates after transplantation have declined, there has emerged an increased focus on reducing longer-term morbidity with improved outcomes in optimizing cardiovascular risk, renal impairment, growth and quality of life. Data were obtained from a review of the literature and particularly from national registries and databases such as the North American Pediatric Renal Trials and Collaborative Studies for the kidney, SPLIT for liver, International Society for Heart and Lung Transplantation and UNOS for intestinal transplantation.

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“…ABOiLDKTx was introduced in Japan because of an extreme shortage of deceased donors and an unexpectedly low incidence of hyperacute rejection (3). In addition, patient and graft survival from ABOiLDKTx have been similar to survival from ABOc since 2001 (2,3). This result may have been caused by the administration of RIT and MMF as desensitizing agents pre-Tx at most kidney transplant centers in Japan since 2000 (4).…”

Section: Discussionmentioning

confidence: 78%

“…However, the incidence of hyperacute rejection is incredibly low (1), and this rejection never occurs if RIT, mycophenolate mofetil (MMF), a steroid, and a calcineurin inhibitor (CNI) are used as desensitizing agents before transplantation. ABOiLDKTx is now very popular in Japan because its outcomes have been demonstrated to be similar to those of ABOcLDKTx (2,3). In addition, pediatric KTx has been adopted for ABOiLDKTx.…”

Section: Introductionmentioning

confidence: 99%

ABO-incompatible living-donor pediatric kidney transplantation in Japan

Aikawa¹,

Kawamura²,

Shishido³

et al. 2014

Clinics

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The Japanese ABO-Incompatible Transplantation Committee officially collected and analyzed data on pediatric ABO-incompatible living-donor kidney transplantation in July 2012. The age of a child was defined as <16 years, and 89 children who had undergone ABO-incompatible living-donor kidney transplantation from 1989 to 2011 were entered in a registry. These data were presented as the Japanese registry of pediatric ABO-incompatible living-donor kidney transplantation at the regional meetings of the International Pediatric Transplantation Association (IPTA) in Nagoya in September 2012 and in Sao Paulo in November 2012.

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Outcomes of Pediatric ABO-Incompatible Kidney Transplantations Are Equivalent to ABO-Compatible Controls

Cited by 28 publications

References 7 publications

Therapeutic plasma exchange for the treatment of pediatric renal diseases in 2013

Therapeutic plasma exchange for the treatment of pediatric renal diseases in 2013

Long-term outcomes of children after solid organ transplantation

ABO-incompatible living-donor pediatric kidney transplantation in Japan

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