NDT Advance Access originally published online on September 27, 2006
Nephrology Dialysis Transplantation 2007 22(1):25-27; doi:10.1093/ndt/gfl557
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
ABO-incompatible transplantationa safe way to perform renal transplantation?
Department of Nephrology, University of Heidelberg, Heidelberg, Germany
Correspondence and offprint requests to: Jörg Beimler, Nierenzentrum Heidelberg, Department of Nephrology, University of Heidelberg, Im Neuenheimer Feld 162, 69120 Heidelberg, Germany. Email: beimler@gmx.de
Keywords: ABO-incompatible renal transplantation; desensitization; immunoadsorption; living kidney donation; plasmapheresis; rituximab
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The shortage of donor organs, especially in renal transplantation, leads to an increasing discrepancy between the number of end-stage renal disease patients on waiting lists and the number of available deceased donor kidneys. Expansion of the donor pool can be achieved by increasing the numbers of living kidney transplantation and by overcoming the immunological barriers of ABO-incompatibility and HLA-sensitization. Despite a substantial increase in the number of patients, receiving living kidney transplant, otherwise suitable donors have to be rejected due to pre-existing human leuocyte antigen antibodies or ABO-incompatibility. Isoagglutinins (ABO-antibodies) represent a major barrier in optimizing living kidney donation and organ distribution. As blood group antigens are expressed by the endothelium of solid organs including the kidney, transplantation across the blood group barrier can result in hyperacute antibody-mediated allograft rejection. Depending on blood group distributions in different populations, as much as 3035% of potential living donors have to be excluded
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| ABO-incompatible renal transplantationquestions to be answered |
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