Turkish Journal of Nephrology
Original Article

Renal Transplantation in Donor Specifi c Antibody Positive Sensitized Patients: Single Center Experience

1.

Ankara Üniversitesi Tıp Fakültesi, Nefroloji Bilim Dalı, Ankara, Türkiye

2.

Ankara Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Ankara, Türkiye

3.

Ankara Üniversitesi Tıp Fakültesi, İmmünoloji Bilim Dalı, Ankara, Türkiye

Turkish J Nephrol 2011; 20: 255-259
DOI: 10.5262/tndt.2011.1003.08
Read: 1427 Downloads: 986 Published: 07 February 2019

In recent years, there are increasing number of sensitized patients waiting for renal transplantation (RTx) who are donor specifi c antibody (DSA) positive and lymphocyte crossmatch (LCM) negative. In this study, we present our transplantation experience in patients with LCM (-) and DSA (+).

We enrolled 4 LCM (-) and panel reactive antibody (PRA) screening positive patients who had a living kidney donor. We evaluated antibodies to determine whether they were DSA or not. If they were DSA, we included these patients in our protocol (DSA level: mean fl uorescein intensity >1000). Two had previous RTx. In our protocol, we started MMF (2gr/day), tacrolimus 0.01 mg/kg, and prednisolone 0.5 mg/kg on day -6. We performed 2 sessions of plasmapheresis (PP) and gave 2 doses of 5 gr/day IVIG. On day -1, 200 mg rituximab was given. On the operation day, the patients received basiliximab. Serum samples were taken on days -6, 0, and 30.

All patients had immediate graft function after RTx. Two patients had acute rejection (AR). Average follow up was 4 months and creatinine levels are 0.7-1.3 mg/dl.

In conclusion, RTx can be succesfully performed in sensitized patients with DSA. However, there seems to be higher acute rejection risk in these patients. 

Files
EISSN 2667-4440