지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2022.6
- 수록면
- 111 - 118 (8page)
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Background: The number of end-stage renal disease (ESRD) patients is increasing in Bangladesh. Currently, living kidney donation is the only viable option for transplan- tation in Bangladesh, and it is further restricted by ABO compatibility issues. We have performed ABO-incompatible kidney transplantations (ABOi KTs) in Bangladesh since 2018. This study examines our experiences with seven cases of ABOi KT.
Methods: The desensitization protocol included low-dose rituximab (100 mg/body) fol- lowed by plasma exchange (PEX), which was followed by a 5-g dose of intravenous im- munoglobulin. Immunosuppression was undertaken using tacrolimus (0.1 mg/kg/day), mycophenolate mofetil (1,500 mg/day), and prednisolone (0.5 mg/kg/day). All patients received basiliximab for induction therapy.
Results: The median baseline anti-ABO antibody titer was 1:64 (range, 1:32?1:128). Transplantation was performed at a titer of ≤1:8. Our patients attended three to five PEX sessions before transplantation. Graft survival was 100% in the seven cases over a mean period of 22 months. The mean creatinine level was 204.6±47.4 μmol/L. Two patients were suspected of having developed acute rejection and received intravenous methylprednisolone, resulting in improved kidney function. One patient required post- transplant hemodialysis due to delayed graft function and subsequently improved. In- fection was the most common complication experienced by ABOi KT patients. Two pa- tients developed severe cytomegalovirus pneumonia and died with functioning grafts. Conclusions: ABOi KT in Bangladesh will substantially expand the living kidney donor pool and bring hope to a large number of ESRD patients without ABO-compatible do- nors. However, the high cost and risk of acute rejection and infection remain major con- cerns.
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