<oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
  <dc:creator>Fehr T</dc:creator>
  <dc:creator>Stussi G</dc:creator>
  <dc:date>2012</dc:date>
  <dc:description xmlns:ns0="xml" ns0:lang="en">PURPOSE OF REVIEW
A dramatic shortage of available organs around the world encouraged attempts to cross previously forbidden immunological boundaries in kidney transplantation. This review focuses on the recent results of ABO-incompatible kidney transplantation.


RECENT FINDINGS
The outcome of ABO-incompatible kidney transplantation in terms of patient and graft survival is comparable to ABO-compatible transplantation for adult and pediatric recipients. Splenectomy has been replaced by the B-cell-depleting agent rituximab to avoid isoagglutinin titer rebound, prevent antibody-mediated rejection, and improve graft survival. However, the risk for infections may be increased and warrants caution. Corticosteroids remain a necessary component of any ABO-incompatible protocol; early as well as late steroid withdrawal may bear an enhanced risk for acute rejection and should only be performed with careful follow-up including protocol biopsies. The few studies that have long-term outcomes using protocol biopsies have characterized a state of accommodation by up-regulation of complement inhibitors, down-regulation of A/B antigens, and establishment of endothelial chimerism over time.


SUMMARY
The experience accumulated around the world indicates that ABO-incompatible kidney transplantation is well tolerated and effective in adults and in children, and it represents an important step forward in expanding the living donor pool. Further understanding of ABO-incompatible graft accommodation may have broader implication also for human leukocyte antigen-sensitized allograft recipients.</dc:description>
  <dc:identifier>https://sonar.ch/global/documents/146832</dc:identifier>
  <dc:language>eng</dc:language>
  <dc:relation>info:eu-repo/semantics/altIdentifier/doi/10.1097/MOT.0b013e328355f013</dc:relation>
  <dc:relation>info:eu-repo/semantics/altIdentifier/pmid/22790072</dc:relation>
  <dc:source>Current opinion in organ transplantation. - 2012</dc:source>
  <dc:subject xmlns:ns1="xml" ns1:lang="en">ABO Blood-Group System</dc:subject>
  <dc:subject xmlns:ns2="xml" ns2:lang="en">Antibodies, Monoclonal, Murine-Derived</dc:subject>
  <dc:subject xmlns:ns3="xml" ns3:lang="en">Desensitization, Immunologic</dc:subject>
  <dc:subject xmlns:ns4="xml" ns4:lang="en">Graft Rejection</dc:subject>
  <dc:subject xmlns:ns5="xml" ns5:lang="en">Graft Survival</dc:subject>
  <dc:subject xmlns:ns6="xml" ns6:lang="en">Humans</dc:subject>
  <dc:subject xmlns:ns7="xml" ns7:lang="en">Immunologic Factors</dc:subject>
  <dc:subject xmlns:ns8="xml" ns8:lang="en">Kidney Transplantation</dc:subject>
  <dc:subject xmlns:ns9="xml" ns9:lang="en">Rituximab</dc:subject>
  <dc:subject xmlns:ns10="xml" ns10:lang="en">Transplantation Tolerance</dc:subject>
  <dc:subject xmlns:ns11="xml" ns11:lang="en">Treatment Outcome</dc:subject>
  <dc:title xmlns:ns12="xml" ns12:lang="en">ABO-incompatible kidney transplantation.</dc:title>
  <dc:type>http://purl.org/coar/resource_type/c_6501</dc:type>
</oai_dc:dc>