PMID- 33316838
OWN - NLM
STAT- MEDLINE
DCOM- 20211213
LR  - 20211214
IS  - 1098-1101 (Electronic)
IS  - 0733-2459 (Linking)
VI  - 36
IP  - 3
DP  - 2021 Jun
TI  - Outcome of desensitization in human leukocyte antigen and ABO incompatible living 
      donor kidney transplantation: Single center experience of first 200 incompatible 
      transplants.
PG  - 299-312
LID - 10.1002/jca.21860 [doi]
AB  - BACKGROUND AND AIMS: Although desensitization is well established, concerns about 
      graft outcome, patient survival and rejection still exist. The present study aims 
      at comparing outcomes of renal transplant recipients across simultaneous ABO and 
      human leukocyte antigen (HLA) incompatibility barriers to those with ABO or HLA 
      incompatibility alone. MATERIALS AND METHODS: This was a retrospective study 
      conducted from October 2015 to December 2018. All patients with a clinical 
      diagnosis of chronic kidney disease, who were prospective HLA incompatible (HLAi) 
      and/or ABO incompatible (ABOi) renal transplant recipients were included. A total 
      of 400 cases including 36 ABOi transplants, 154 HLAi transplants, 10 
      simultaneously ABO and HLA incompatible transplants, and 200 ABO (ABOc) and HLA 
      (HLAc) compatible kidney transplants from living donors were included. RESULTS: 
      There were significantly more number of blood transfusions, previous transplants 
      and pregnancies in HLAi transplant recipients relative to the ABOi or the control 
      group. Mean number of therapeutic plasma exchange procedures per patient and mean 
      plasma volume processed per procedure were slightly higher in the ABOi + HLAi 
      category. The incidence of graft dysfunction due to suspected antibody-mediated 
      rejection during first year was highest in the ABOi + HLAi group, followed by 
      ABOc + HLAi and ABOi + HLAc, lowest in the ABOc + HLAc category. Mean time to 
      first episode of graft dysfunction was significantly shorter with incompatible 
      transplants. There were no kidney transplant recipient deaths in the study. 
      CONCLUSION: Patient outcome and graft outcomes observed with incompatible 
      transplants were not worse than those observed with compatible transplants.
CI  - (c) 2020 Wiley Periodicals LLC.
FAU - Pandey, Prashant
AU  - Pandey P
AUID- ORCID: 0000-0001-8861-8152
AD  - Department of Transfusion Medicine, Histocompatibility and Molecular Biology, 
      Jaypee Hospital, Noida, India.
FAU - Setya, Divya
AU  - Setya D
AUID- ORCID: 0000-0003-2593-5235
AD  - Department of Transfusion Medicine, Histocompatibility and Molecular Biology, 
      Jaypee Hospital, Noida, India.
FAU - Sinha, Vijay Kumar
AU  - Sinha VK
AD  - Department of Nephrology and Renal Transplantation, Jaypee Hospital, Noida, 
      India.
FAU - Devra, Amit K
AU  - Devra AK
AD  - Department of Nephrology and Renal Transplantation, Jaypee Hospital, Noida, 
      India.
FAU - Bhatt, Anil Prasad
AU  - Bhatt AP
AD  - Department of Nephrology and Renal Transplantation, Jaypee Hospital, Noida, 
      India.
FAU - Pande, Amit
AU  - Pande A
AD  - Department of Transfusion Medicine, Histocompatibility and Molecular Biology, 
      Jaypee Hospital, Noida, India.
FAU - Kumar, Praveen
AU  - Kumar P
AD  - Department of Transfusion Medicine, Histocompatibility and Molecular Biology, 
      Jaypee Hospital, Noida, India.
FAU - Singh, Mukesh Kumar
AU  - Singh MK
AD  - Department of Transfusion Medicine, Histocompatibility and Molecular Biology, 
      Jaypee Hospital, Noida, India.
FAU - Ranjan, Shweta
AU  - Ranjan S
AD  - Department of Transfusion Medicine, Histocompatibility and Molecular Biology, 
      Jaypee Hospital, Noida, India.
LA  - eng
PT  - Journal Article
DEP - 20201214
PL  - United States
TA  - J Clin Apher
JT  - Journal of clinical apheresis
JID - 8216305
RN  - 0 (ABO Blood-Group System)
RN  - 0 (HLA Antigens)
SB  - IM
MH  - ABO Blood-Group System/*immunology
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - *Blood Group Incompatibility
MH  - Female
MH  - Graft Rejection/etiology
MH  - Graft Survival
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - *Kidney Transplantation/mortality
MH  - *Living Donors
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Young Adult
OTO - NOTNLM
OT  - ABO incompatible
OT  - desensitization
OT  - donor specific anti-HLA antibodies
OT  - incompatible kidney transplant
OT  - preconditioning
OT  - therapeutic plasma exchange
EDAT- 2020/12/15 06:00
MHDA- 2021/12/15 06:00
CRDT- 2020/12/14 20:16
PHST- 2020/08/20 00:00 [revised]
PHST- 2020/07/08 00:00 [received]
PHST- 2020/11/12 00:00 [accepted]
PHST- 2020/12/15 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2020/12/14 20:16 [entrez]
AID - 10.1002/jca.21860 [doi]
PST - ppublish
SO  - J Clin Apher. 2021 Jun;36(3):299-312. doi: 10.1002/jca.21860. Epub 2020 Dec 14.