Successful A2 to B Deceased Donor Kidney Transplant after Desensitization for High-Strength Non-HLA Antibody Made Possible by Utilizing a Hepatitis C Positive Donor
Desensitization using plasma exchange can remove harmful antibodies prior to transplantation and mitigate risks for hyperacute and severe early acute antibody-mediated rejection. Traditionally, the use of plasma exchange requires a living donor so that the timing of treatments relative to transplant...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2020/3591274 |
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| author | H. Charli Karpel Nicole M. Ali Nikki Lawson Vasishta S. Tatapudi Rex Friedlander Mary Carmelle Philogene Robert A. Montgomery Bonnie E. Lonze |
| author_facet | H. Charli Karpel Nicole M. Ali Nikki Lawson Vasishta S. Tatapudi Rex Friedlander Mary Carmelle Philogene Robert A. Montgomery Bonnie E. Lonze |
| author_sort | H. Charli Karpel |
| collection | DOAJ |
| description | Desensitization using plasma exchange can remove harmful antibodies prior to transplantation and mitigate risks for hyperacute and severe early acute antibody-mediated rejection. Traditionally, the use of plasma exchange requires a living donor so that the timing of treatments relative to transplant can be planned. Non-HLA antibody is increasingly recognized as capable of causing antibody-mediated renal allograft rejection and has been associated with decreased graft longevity. Our patient had high-strength non-HLA antibody deemed prohibitive to transplantation without desensitization, but no living donors. As the patient was eligible to receive an A2 ABO blood group organ and was willing to accept a hepatitis C positive donor kidney, this afforded a high probability of receiving an offer within a short enough time frame to attempt empiric desensitization in anticipation of a deceased donor transplant. Fifteen plasma exchange treatments were performed before the patient received an organ offer, and the patient was successfully transplanted. Hepatitis C infection was treated posttransplant. No episodes of rejection were observed. At one-year posttransplant, the patient maintains good graft function. In this case, willingness to consider nontraditional donor organs enabled us to mimic living donor desensitization using a deceased donor. |
| format | Article |
| id | doaj-art-8fa879d47b0b4289917fb448333bc7fd |
| institution | OA Journals |
| issn | 2090-6943 2090-6951 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-8fa879d47b0b4289917fb448333bc7fd2025-08-20T02:09:28ZengWileyCase Reports in Transplantation2090-69432090-69512020-01-01202010.1155/2020/35912743591274Successful A2 to B Deceased Donor Kidney Transplant after Desensitization for High-Strength Non-HLA Antibody Made Possible by Utilizing a Hepatitis C Positive DonorH. Charli Karpel0Nicole M. Ali1Nikki Lawson2Vasishta S. Tatapudi3Rex Friedlander4Mary Carmelle Philogene5Robert A. Montgomery6Bonnie E. Lonze7Transplant Institute, NYU Langone Health, New York, NY, USATransplant Institute, NYU Langone Health, New York, NY, USATransplant Institute, NYU Langone Health, New York, NY, USATransplant Institute, NYU Langone Health, New York, NY, USAThe Rogosin Institute, New York, NY, USAAmerican Red Cross, Penn Jersey Region, Philadelphia, PA, USATransplant Institute, NYU Langone Health, New York, NY, USATransplant Institute, NYU Langone Health, New York, NY, USADesensitization using plasma exchange can remove harmful antibodies prior to transplantation and mitigate risks for hyperacute and severe early acute antibody-mediated rejection. Traditionally, the use of plasma exchange requires a living donor so that the timing of treatments relative to transplant can be planned. Non-HLA antibody is increasingly recognized as capable of causing antibody-mediated renal allograft rejection and has been associated with decreased graft longevity. Our patient had high-strength non-HLA antibody deemed prohibitive to transplantation without desensitization, but no living donors. As the patient was eligible to receive an A2 ABO blood group organ and was willing to accept a hepatitis C positive donor kidney, this afforded a high probability of receiving an offer within a short enough time frame to attempt empiric desensitization in anticipation of a deceased donor transplant. Fifteen plasma exchange treatments were performed before the patient received an organ offer, and the patient was successfully transplanted. Hepatitis C infection was treated posttransplant. No episodes of rejection were observed. At one-year posttransplant, the patient maintains good graft function. In this case, willingness to consider nontraditional donor organs enabled us to mimic living donor desensitization using a deceased donor.http://dx.doi.org/10.1155/2020/3591274 |
| spellingShingle | H. Charli Karpel Nicole M. Ali Nikki Lawson Vasishta S. Tatapudi Rex Friedlander Mary Carmelle Philogene Robert A. Montgomery Bonnie E. Lonze Successful A2 to B Deceased Donor Kidney Transplant after Desensitization for High-Strength Non-HLA Antibody Made Possible by Utilizing a Hepatitis C Positive Donor Case Reports in Transplantation |
| title | Successful A2 to B Deceased Donor Kidney Transplant after Desensitization for High-Strength Non-HLA Antibody Made Possible by Utilizing a Hepatitis C Positive Donor |
| title_full | Successful A2 to B Deceased Donor Kidney Transplant after Desensitization for High-Strength Non-HLA Antibody Made Possible by Utilizing a Hepatitis C Positive Donor |
| title_fullStr | Successful A2 to B Deceased Donor Kidney Transplant after Desensitization for High-Strength Non-HLA Antibody Made Possible by Utilizing a Hepatitis C Positive Donor |
| title_full_unstemmed | Successful A2 to B Deceased Donor Kidney Transplant after Desensitization for High-Strength Non-HLA Antibody Made Possible by Utilizing a Hepatitis C Positive Donor |
| title_short | Successful A2 to B Deceased Donor Kidney Transplant after Desensitization for High-Strength Non-HLA Antibody Made Possible by Utilizing a Hepatitis C Positive Donor |
| title_sort | successful a2 to b deceased donor kidney transplant after desensitization for high strength non hla antibody made possible by utilizing a hepatitis c positive donor |
| url | http://dx.doi.org/10.1155/2020/3591274 |
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