ArticlePediatric nephrology (Berlin, Germany)2020
ABO-incompatible pediatric kidney transplantation without antibody removal.
Article in Pediatric nephrology (Berlin, Germany), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 22 citations in OpenAlex.
- Paediatric ABO-incompatible kidney transplantation: re-evaluating desensitisation protocols without plasma exchange.Pediatric nephrology (Berlin, Germany) · 2026Article
- The history and future landscape for paediatric ABO incompatible kidney transplantation.Pediatric nephrology (Berlin, Germany) · 2026Review
- Change in bladder capacity and prognostic predictors of post-transplant vesicoureteral reflux in pediatric kidney transplant recipients: a single-center retrospective cohort study.Pediatric nephrology (Berlin, Germany) · 2026Article
- ABO-incompatible kidney transplantation: impact of apheresis on graft and patient survival in recipients with low isoagglutinin titer.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Safety and efficacy of rituximab-free ABO incompatible kidney transplantation: a German multicenter cohort study.Frontiers in nephrology · 2026Article
- First ABO-Incompatible Pediatric Kidney Transplant in South Africa-A Case Report.Pediatric transplantation · 2025Article
- Non-antigen-specific Immunoadsorption Is a Risk Factor for Severe Postoperative Infections in ABO-Incompatible Kidney Transplant Recipients.Transplant international : official journal of the European Society for Organ Transplantation · 2024Article
- Case Report: Successful ABO-Incompatible Deceased Donor Kidney Transplantation in an Infant Without Pre-transplant Immunological Treatment.Frontiers in medicine · 2022Article
- Use of rituximab in paediatric nephrology.Archives of disease in childhood · 2021Review
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBecause of the severe shortage of suitable deceased donors, ABO-incompatible living donor kidney transplantation (ABOi LDKT) is performed even in pediatric recipients in Japan. We performed pediatric ABOi LDKT using rituximab without anti-A/B antibody removal.
methodsThirteen pediatric recipients (mean age 7.4, range 3.4-15.7, four females) whose baseline anti-A/B IgG titers were ≤ × 64 underwent ABOi LDKT without antibody removal and splenectomy between July 2013 and April 2017 at Toho University. Mycophenolate mofetil (MMF) was initiated on day - 10. Rituximab (100 mg) was administered twice. Basiliximab and triple maintenance immunosuppression (calcineurin inhibitor, MMF, and steroids) were administered. Protocol biopsy was performed at 3 months and 1 year after transplantation. We retrospectively compared the clinical outcomes between these recipients and 37 children (mean age 9.0, range 2.6-18.9, 15 female) who underwent ABO-compatible (ABOc) LDKT during the same period.
resultsThe mean follow-up periods of ABOi and ABOc groups were 31.9 ± 13.5 and 28.8 ± 14.4 months, respectively. In the ABOi group, no clinical acute rejection (AR) was noted and subclinical AR was observed in four patients without evidence of acute antibody-mediated rejection. In the ABOc group, clinical and subclinical AR developed in 3 and 10 patients, respectively. No significant difference was identified for the mean eGFR between the ABOi and ABOc groups (98.3 ± 48.8 vs. 86.9 ± 39.4, P = 0.452 at 3 months; 78.2 ± 21.2 vs. 79.7 ± 21.3, at 1 year, P = 0.830). Death-censored graft survival at follow-up was 100% in the ABOi group and 94.6% in the ABOc group. Patient survival during the follow-up period in both the groups was 100%. Late-onset neutropenia (LON) requiring granulocyte colony-stimulating factor occurred more frequently in the ABOi group than in the ABOc group (4 vs. 0 patients) (P < 0.001).
conclusionsPre- and post-transplantation antibody removal is not a prerequisite for successful pediatric ABOi LDKT, at least in patients with a low anti-A/B IgG antibody titer. However, LON caused by rituximab should be monitored.
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