Asian Journal of Transfusion Science
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Year : 2017  |  Volume : 11  |  Issue : 1  |  Page : 45-49

ABO incompatible renal transplant: Transfusion medicine perspective

1 Department of Transfusion Medicine and Immunohematology, Indraprastha Apollo Hospitals, New Delhi, India
2 Department of Nephrology, Indraprastha Apollo Hospitals, New Delhi, India

Correspondence Address:
Sweta Nayak
Department of Transfusion Medicine and Immunohematology, Indraprastha Apollo Hospitals, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0973-6247.200767

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Introduction: Our study presents an analysis of the trends of ABO antibody titers and the TPE (Therapeutic Plasma Exchange) procedures required pre and post ABO incompatible renal transplant. Materials and Methods: Twenty nine patients underwent ABO incompatible renal transplant during the study period.The ABO antibody titers were done using the tube technique and titer reported was the dilution at which 1+ reaction was observed. The baseline titers of anti-A and anti-B antibodies were determined. The titer targeted was ≤8. Patients were subjected to 1 plasma volume exchange with 5% albumin and 2 units of AB group FFP (Fresh Frozen Plasma) in each sitting. TPE procedures post-transplant were decided on the basis of rising antibody titer with/ without graft dysfunction. Results: The average number of TPE procedures required was 4-5 procedures/patient in the pretransplant and 2-3/patient in the post-transplant period. An average titer reduction of 1 serial dilution/procedure was noted for Anti-A and 1.1/procedure for Anti-B. Number of procedures required to reach the target titer was not significantly different for Anti-A and Anti-B (P = 0.98). Outcome of the transplant did not differ significantly by reducing titers to a level less than 8 (P = 0.32). The difference in the Anti-A and Anti-B titers at 14th day post-transplant was found to be clinically significant (P = 0.042). Conclusion: With an average of 4-5 TPE procedures pretransplant and 2-3 TPE procedures post transplants, ABO incompatible renal transplantations can be successfully accomplished.

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2006 - Asian Journal of Transfusion Science | Published by Wolters Kluwer - Medknow
Online since 10th November, 2006