Abstract
We have performed ten pediatric kidney transplantations from living-related ABO-incompatible donors. All patients underwent preoperative plasmapheresis with or without immunoadsorption to reduce isoagglutinin. Primary immunosuppression consisted of methylprednisolone, cyclosporin or tacrolimus, azathioprine, anti-lymphocyte globulin, and/or deoxyspergualin. At transplantation splenectomy was simultaneously performed in all patients. Median follow-up is 65 months (range 4–95 months). The patient and graft survival rates are 100% to date. Post-transplantation isoagglutinin titers did not increase more than 1:32, except for 1 patient, without uncontrollable vascular rejection episodes. Despite the heavy immunosuppressive regimen, cytomegalovirus infection occurred in only three patients, who were successfully treated with ganciclovir and cytomegalovirus high-titer gamma globulin. Our small series clearly shows that the preoperative reduction of isoagglutinin, splenectomy, and strict immunosuppressive therapy lead to successful long-term results in children.
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Received: 3 July 1998 / Revised: 13 January 1999 / Accepted: 14 January 1999
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Ohta, T., Kawaguchi, H., Hattori, M. et al. ABO-incompatible pediatric kidney transplantation in a single-center trial. Pediatr Nephrol 14, 1–5 (2000). https://doi.org/10.1007/s004670050001
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DOI: https://doi.org/10.1007/s004670050001