توجه: محتویات این صفحه به صورت خودکار پردازش شده و مقاله‌های نویسندگانی با تشابه اسمی، همگی در بخش یکسان نمایش داده می‌شوند.
۱Early post–transplant complications following ABO–incompatible kidney transplantation
اطلاعات انتشار: Journal of nephropathology، پنجم،شماره۱، Jan ۲۰۱۶، سال
تعداد صفحات: ۹
Background: Living–kidney transplantation is increasing because of the scarcity of kidneys from deceased donors and the increasing numbers of patients on waiting lists for a kidney transplant. Living–kidney transplantation is now associated with increased long–term patient– and allograft–survival rates. Objectives: The purpose of this retrospective study was to identify, in a cohort of 44 ABO–incompatible (ABOi) live–kidney transplant patients, the main complications that occurred within 6 months post–transplantation, and to compare these findings with those from 44 matched ABO–compatible (ABOc) live–kidney transplant patients who were also from our center.Patients and Methods: This single–center retrospective study assessed post–transplantation complications in 44 ABO–i versus 44 matched ABO–c patients. All patients were comparable at baseline except that ABO–i patients had greater immunological risks. Results: During the 6–month post–transplant period, more ABO–i patients presented with postoperative bleeds, thus requiring significantly more blood transfusions. Bleeds were associated with significantly lower values of fibrinogen, platelets, prothrombin time, and hemoglobin levels. Surgical complications, patient– and graft–survival rates, and kidney–function statuses were similar between both groups at 6 months post–transplantation. Conclusions: We conclude that impairment of hemostatic factors at pre–transplant explained the increased risk of a post–transplant bleed in ABO–i patients.

۲Treatment of large plasma volumes using specific immunoadsorption to desensitize ABO–incompatible kidney–transplant candidates
اطلاعات انتشار: Journal of nephropathology، پنجم،شماره۳، Jul ۲۰۱۶، سال
تعداد صفحات: ۸
Background: ABO–incompatible (ABOi) kidney–transplantation has very good long–term results, i.e. similar to those observed for living–kidney ABO–compatible transplantation. This is because patients are desensitized at pretransplant using apheresis and rituximab therapy, with tacrolimus–based immunosuppression. Objectives: To assess the efficacy of a single, pretransplant (Day –1), specific immunoadsorption session using Glycosorb® columns (anti–A or anti–B; Glycorex Sweden) to treat large volumes of plasma (up to 18 L). Patients and Methods: Prospective single–center study evaluating 12 consecutive patients (6 males), aged 40 (23–59) years. Incompatibilities were A into 0 (8), B into 0 (3), and AB into 0 (1). Pretransplant desensitization relied on rituximab (D–30), tacrolimus, mycophenolic acid, and steroids (all started on D–13), and a single session of specific immunoadsorption on D–1. Immunoadsorption was coupled in tandem with a hemodialysis session. Results: Overall, 15 L (11–18) of plasma were treated per patient, i.e., 0.2 (0.11–0.36 L\kg). Isoagglutinin titers were 1\16 (1\5–1\64) before the procedure, decreasing after 6 hours to 1\5 (1\1–1\16 P = 0.008), and to 1\2 (1\1–1\8; P = 0.05) at completion of the session. The next day, i.e., the day of transplantation, there was no rebound of isoagglutinins [1\4 (1\1–1\5); P = ns]. The procedure was well tolerated with no side–effects and no significant changes in hemoglobin level, platelet counts, fibrinogen, or albumin levels.Conclusions: For ABOi kidney–transplantation, a single, longer, specific immunoadsorption session was very efficient at 1–day pre–transplantation with no rebound. These results should be confirmed when isoagglutinin titers are higher (≥120).
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