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Article Abstract
Background: The introduction of rituximab has contributed to successful living donor kidney transplantations in ABO-incompatible recipients and has replaced splenectomy for desensitization. However, several reports still suggest that postoperative splenectomy may be effective in preventing graft failure in patients with acute antibody-mediated kidney transplant rejection (AAMR) in kidney transplantation. Therefore, we aim to assess if preoperative splenectomy also could be an alternative practical choice to avoid AAMR in high-risk rejection cases such as flow cytometry crossmatch (FCXM)-positive cases.
Material And Method: We carried out 4 living donor kidney transplantations in FCXM-positive cases: 3 underwent pretransplant splenectomy, and 1 did not.
Results: All 3 cases in whom pretransplant splenectomy was performed were discharged without rejection. On the contrary, in the case where pretransplant splenectomy was not performed, there was graft rejection and additional desensitization therapies were needed.
Conclusion: While larger clinical studies with longer observation periods are needed, our report suggested that pretransplant splenectomy may lead to successful short-term kidney transplantation outcomes in FCXM-positive cases.
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| http://dx.doi.org/10.1016/j.transproceed.2020.02.129 | DOI Listing |
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Article Synopsis
- Liver transplantation (LT) is essential for patients with acute-on-chronic liver failure (ACLF) when other treatments fail, but the success of LT for patients with acute pancreatitis (AP) has been inconsistent.
- A case study highlights the first successful living donor LT (LDLT) for a 38-year-old woman whose ACLF was triggered by severe AP, complicated by immune issues.
- The patient's generous care included intensive therapy for her AP and personalized desensitization procedures, leading to a successful transplant without postoperative complications or AP recurrence.