16th Congress of the Asian Society of TransplantationKidney transplantationOne-Year Outcomes of Living Related Kidney Transplant in Patients With Preformed HLA Donor-Specific Antibodies: A Single-Center Experience in Malaysia
Section snippets
Materials and Methods
This was a prospective cohort study recruiting all KTRs from August 2016 until September 2018. Deceased donations, ABOIs, and those sensitized patients who were not prescribed on our desensitization protocol were excluded. Those with positive HLA-DSAs will undergo flow cytometry (risk stratification). We are using a protocol that consisted of intravenous rituximab 200 mg (day -14 prior to transplant), intravenous antithymocyte globulin (Thymoglobulin) 5 mg/kg (day 0-4), plasma exchange post
Results
A total of 40 patients were recruited, and 20 were sensitized KTRs. The mean age was 39.0 (SD, 11.99) years, and 23 of 40 (57.5%) were male. The primary diseases of end-stage kidney disease in our cohort were diabetes mellitus followed by hypertension, lupus nephritis, IgA nephropathy, and unknown etiology. Table 1 shows baseline demographic of our KTRs and their donors. Dialysis vintage was significantly longer in KTRs with preformed HLA-DSA at 48.35 (SD, 57.18) months compared with the
Discussion
Transplant across HLA incompatibilities and ABOIs is important in developing countries with limited deceased donation and suitable potential donors. This has been shown to confer significant survival benefit compared with waiting for a compatible organ and being on dialysis [5]. There are various published desensitization protocols and many more new agents in the pipeline. In our cohort we were using desensitization with anti-CD20 low-dose rituximab and plasma exchange. All of our patients had
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