Journal List > J Korean Soc Transplant > v.28(1) > 1034446

Lee, Hyun, Kyu, and Myoung: Successful Pediatric ABO-Incompatible Kidney Transplantation without Pretransplant Plasmapheresis: Report of a Case


Immunologic responses of infants and younger children differ from those of adults. Therefore, application of different pretransplant strategies for antibody depletion in younger ABO-incompatible transplant recipients is appropriate. A 12-month-old male infant with end stage renal disease after acute tubular necrosis was scheduled to undergo kidney transplantation from an ABO-incompatible living donor. He did not undergo pretransplant plasmapheresis, as the titer of the anti-ABO antibody was less than 1:4. After kidney transplantation, posttransplant renal function and anti-ABO titers were stable until posttransplant 2 years.


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Fig. 1.
Renogram on postoperative day 8. Normal cortical transit and renal excretion of the radiotracers. Transplanted kidney shows within normal limits of blood flow and uptake.
Table 1.
Anti-B antibody titer and renal function
  Pretransplant Discharge day (POD #10) Postoperative
6 mo 1 yr 2 yr
Anti-B IgM 1:4 P 1:1 P N N N
Anti-B IgG <1:2 N <1:2 N <1:2 N <1:2 N <1:2 N
BUN (mg/dL) 60.6 16.1 21.0 17.5 20.9
Creatinine (mg/dL) 2.39 0.22 0.53 0.50 0.44

Abbreviations: POD, postoperative day; IgM, immunoglobulin M; IgG, immunoglobulin G; P, positive; N, negative; BUN, blood urea nitrogen.

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