ABO-incompatible transplantation without conventional induction immunosuppression (IL-2RB or depleting agents)‎

Abstract EN

Transplantation across the ABO blood group (ABOI-Tx) has facilitated to increase in donor pool for living donor kidney transplantation.

Increased risk of rejection despite augmented immunosuppression has been the concern for many transplant programs in initiating an ABOI-TX program.

The benefits of induction immunosuppression on long-term graft survival in immunologically low-risk individuals are still not clear.

Increased immunosuppression of ABOI-Tx recipients before transplantation could provide an opportunity to transplant without induction with IL2-R blockers or Lymphocyte depleting agents.

The aim of our study is to analyze the outcome of our series of 25 consecutive ABOI-Tx patients who underwent transplantation without routine thymoglobulin or IL2R-blocker induction.

Our study is a prospective observational study for the first 25 consecutive patients who had undergone ABOI-Tx from two tertiary care centers in Kerala, India, having the same IS protocol.

Anti-A and anti-B titers ≤1:512 by Gel-method (Biorad) were accepted for desensitization.

Patients underwent CDC- crossmatch, Flow-crossmatch, and Luminex-anti-HLA-antibody-screen.

Desensitization regimen included- Rituximab 200 mg on Day-21, Triple IS Prednisolone 10 mg, mycophenolate mofetil 1000 mg, and Tacrolimus 0.06 mg/bodywt from Day-14 and Plasma-exchange (PLEX) 3-4 sessions from day -7 to attain titer of 1:8 before transplantation.

Transplantation was done without induction IS.

Twenty-five patients underwent ABOI-Tx from both centers.

Twenty recipients were male.

The average age was 34.5 ± 8 years with follow-up of 503 ± 120 days.

Eight donors