Kidney Transplantation from АВ0-Incompatible Living Family Donor

Abstract

The introduction into the clinical practice of kidney transplantation from АВ0-incompatible living donor may be one of the ways to solve the problem of shortage of cadaveric donor organs. The objective of this study was to analyze the first 4 such surgeries performed at the National Institute of Surgery and Transplantology named after O.O. Shalimov of National Academy of Medical Sciences of Ukraine. Special pretransplantation preparation of patients included introduction of rituximab, intravenous immunoglobulin, sessions of specific immune adsorption to remove anti-A/B antibodies and administration of immunosuppressants 2 weeks prior to surgery. Subsequently, recipients received a traditional 4-component immunosuppressive therapy (+ basiliximab), which differed from the usual one only by slightly larger doses of tacrolimus. In all cases, we observed satisfactory restoration of the function of the kidney transplant. The crises of acute kidney rejection were not detected. Two patients had episodes of acute pyelonephritis treated with antibiotics. Follow-up period ranged from 5 to 18 months. The survival rate of recipients and transplants currently is 100 %. Conclusion: АВ0-incompatible kidney transplantation from a living family donor is a promising direction of transplanto­logy, whose development in Ukraine may to some extent solve the problem of acute shortage of cadaveric donor organs.