ABO-incompatible kidney transplantation using immunoadsorption columns: First experiences in South Africa

Abstract

Background. ABO-incompatible kidney transplantation gives patients with chronic kidney disease requiring dialysis and without a blood group-compatible donor an alternative option for a kidney transplant. Objectives. To describe our first experiences and outcomes with 3 patients using Glycosorb ABO immunoadsorption (IA) columns in performing ABO-incompatible living-donor kidney transplants. This is the first time this technique has been used in Africa. Methods. As per the protocol, patients needed between 1 and 4 sessions of IA and received rituximab ~ one month before transplantation. Results. All the patients achieved the target isohaemagglutinin antibody titre of 1:4 pretransplant. Only 1 patient with the highest initial screening titre (1:256) needed IA post-transplant. None of the patients experienced clinical rejection, and all had good graft kidney function at discharge and at the time of writing. Conclusion. Glycosorb ABO IA is an effective technique in enabling ABO-incompatible living-donor kidney transplants to be performed successfully in a South African setting.