Accommodation in ABO-incompatible Kidney Transplantation
Elsevier, 2004 - Medical - 209 pages
For most people today, ABO-incompatible kidney transplantation still carries the image of pronounced hyperacute rejection. However, with modern immunosuppressive therapy, hyperacute rejection will not occur within the first 24 hours. Clinical statistics in Japan show 3 cases of hyperacute rejection, but all of these occurred because the recipient was mistakenly transfused during surgery with frozen plasma of the same blood type. Delayed hyperacute rejection, occurring after the first 24 hours, is most likely to develop within 1 week post transplant. It does not manifest suddenly, but several years after transplantation. This means that humoral rejection ceases to occur after accommodation has been established. The use of evidence-based medicine to correct misconceptions in this area has proven to be meaningful.
The publication of these data has made it possible to break down fixed thinking and prejudices previously regarded as fact in relation to ABO-incompatible kidney transplantation. It is believed that this will prove to be a major contribution in the future development of immunology. As these data are provided as a common resource for physicians performing transplantation procedures, it has encouraged more widespread implementation of organ transplantation.
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Accommodation in ABOincompatible kidney
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ABO blood group ABO-incompatible kidney transplantation ABO-incompatible transplantation accommodation acute rejection allograft anti-A/anti-B antibody anti-B antibody titer antibody production antibody removal antibody titer anticoagulation therapy artery azathioprine basiliximab biopsy Biosynsorb blood group antigens blood group glycosyltransferase calcineurin inhibitor cellular rejection ciclosporin clinical course delayed hyperacute rejection deoxyspergualin developed DFPP dialysis dose drug endothelial cells factors ganciclovir glycosyltransferase graft loss Graft survival rate HD HD hemodialysis HLA-A immunoadsorption immunosuppressive therapy incompatible kidney transplantation induction period infection inhibit Japanese kidney grafts living kidney transplantation lymphocyte methylprednisolone mg/day mg/dl mg/kg/day mizoribine month posttransplant mycophenolate mofetil ng/ml OKT3 outcome of ABO-incompatible performed plasma exchange plasmapheresis pretransplant procedure pulse therapy recipient renal transplantation Saito serum creatinine splenectomy suppress surgery T-cell tacrolimus Takahara Takahashi Tanabe Transplant 2003 transplant kidney transplant patients Transplant Proc transplantation in Japan treatment trough level vascular endothelial cells