Current status of ABO-incompatible kidney transplantation in children

被引：11

作者：

Shishido, S

Hasegawa, A

机构：

[1] Tokyo Metropolitan Kiyose Childrens Hosp, Dept Pediat Urol & Kidney Transplantat, Kiyose, Tokyo 2048567, Japan

[2] Univ Tokyo, Sch Med, Dept Nephrol, Tokyo 113, Japan

来源：

PEDIATRIC TRANSPLANTATION | 2005年 / 9卷 / 02期

关键词：

ABO incompatibility; kidney transplantation; plasmapheresis; immunoadsorpsion; splenectomy; hyperacute rejection; acute humoral rejection; accommodation;

D O I：

10.1111/j.1399-3046.2004.00234.x

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

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 associated high risk for hyperacute rejection. However, due to a severe shortage of suitable cadaveric allografts, much effort has been made over the last 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 children with end stage renal disease. In this review, we will discuss protocols available for successfully performing ABO-incompatible kidney transplantation in children: (1) pre-transplant extracorporeal immunomodulation with removal of pre-existing anti-A and/or anti-B antibodies; (2) immunosuppressive therapy and anti-rejection therapy; (3) splenectomy and the associated infectious complication in asplenic children. Also, we will speculate regarding the mechanisms underlying accommodation following transplantation.

引用

页码：148 / 154

页数：7

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