The murine monoclonal antibody (OKT-3) and plasmapheresis therapy were applied in combination to treat acute renal allograft rejection in 31 patients who were not responsive to conventional bolus steroid treatment. Six of them were living related but ABO incompatible; another 25 patients were ABO compatible (1 was from a cadaver, 7 were from living unrelated donors, and 17 were from living related donors). Of these 31 patients, 25 (80.65%) showed perfect improvement in their graft function. These 25 patients had a mean follow-up time of 8 months, and had mean creatinine values of 1.2 mg% (0.8-2.8 mg%). It is concluded that OKT-3 and plasmapheresis combination therapy is very effective in reversing steroid-resistant rejections in high-risk patients such as ABO-incompatible cases.

Adolescent↗

PubMed1991

ABO-incompatible kidney transplantation with donor-specific skin graft.

From November 3, 1975, to May 31, 1989, 711 (548 living-related and 163 cadavers) kidney transplantations were performed in our centers. In the final 2 years, 15 ABO-incompatible living related kidney transplantations were performed. In 4 cases, the recipient's blood groups was O and the donor's A1. In 3 cases the blood group of the recipient was A1 and the donor's AB, two patients were B with the donors A1 and the other 2 were O with donors B. The other 3 recipients group was B and the donors' were AB. The donors' and recipients' HLA-AB typing showed one haplotype matching in 12 and two haplotypes matching in 3 patients. The donors were mothers in 7 cases, sibling in 5, and father in 3 cases. At least 3 weeks before the renal transplantation, donor-specific skin grafts and subsequently splenectomy were performed on 9 recipients, but on 6 recipients without splenectomy. Following the skin graft, cross-match was done starting from the 15th day and then continued every week. The immunosuppression, which consisted of triple drugs (0.5 mg/kg prednisolone, 2 mg/kg cyclosporin-A and 2 mg/kg azathioprine) was followed by skin graft. Renal transplantation was performed according to cross-match and skin graft results, and all recipients prior to surgery received at least two sessions of plasmapheresis. Regular dose of immunosuppression that included triple drugs were used after the kidney transplantation and then Orthoclone OKT-3 and plasmapheresis were applied during the rejection episodes without bolus therapy. All patients were followed for 5 to 24 months (ave. 14,13 months).(ABSTRACT TRUNCATED AT 250 WORDS)

ABO Blood-Group System↗

PubMed1991

Liver transplantation in Turkey.

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Adolescent↗