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 CASE REPORT
Year : 2013  |  Volume : 23  |  Issue : 3  |  Page : 214-216

Renal transplantation across ABO barrier


1 Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta the Medicity, Gurgaon, Haryana, India
2 Medanta Department of Transfusion Medicine, Medanta the Medicity, Gurgaon, Haryana, India

Correspondence Address:
P N Gupta
Department of Nephrology, Medanta the Medicity, Sector 38, Gurgaon -122 001, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-4065.111857

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In India, patients without a compatible blood group donor are usually excluded from renal transplantation. For young patients, it is a difficult therapeutic choice to stay on long-term dialysis. We describe the case of a 19-year-old male patient who had blood group O +ve and had no compatible donor in the family. His mother was B +ve and was willing to donate. The patient had an initial anti-B antibody titer of 1:512 and underwent antibody depletion with plasmapheresis (11 sessions) and intravenous immunoglobulin (IVIG) 100 mg/kg after every plasmapheresis. He also received rituximab 500 mg for 3 days prior to transplant and was induced with basiliximab. At the time of transplant, his anti-B titers were <1:8. Post-operatively, he required four sessions of plasmapheresis and IVIG as his titers rebounded to 1:64. The titers then spontaneously subsided to <1:16 and have stayed at the same level for 6 months post-transplant. The patient continues to have normal renal function with a creatinine of 1.4 mg/dl% and has had no episodes of rejection.






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Indian Journal of Nephrology
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Online since 20th Sept '07