alexa ABO-incompatible living-donor kidney transplantation in children.


Journal of Kidney

Author(s): Shishido S

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This article reviews the current status of ABO-incompatible kidney transplantation in the pediatric population. ABO blood type incompatibility between a donor and recipient was generally considered a contraindication to kidney transplantation because of the asso- ciated high risk for hyperacute rejection. However, due to a severe shortage of suitable cadaveric allografts, much effort has been made over the past decade to investigate whether successful and effective kidney transplantation is possible across the ABO blood group barrier. At present, ABO-incompatible kidney transplantation has been shown to be a valid alternative even for small children with end-stage renal disease. In this review, the author will discuss protocols available for successfully performing ABO- incompatible kidney transplantation in children: pretransplant extracorporeal im- munomodulation with removal of preexisting anti-A and/or anti-B antibodies, immuno- suppressive therapy and antirejection therapy, and splenectomy and the associated infectious complication in asplenic children. Also, the author will speculate with regard to the mechanisms underlying accommodation following transplantation.

This article was published in Graft and referenced in Journal of Kidney

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