Living donor kidney transplantation across positive crossmatch: the University of Illinois at Chicago experience.

摘要: BACKGROUND To increase living donation for kidney transplantation, we investigated desensitization of recipients with positive crossmatch against a potential donor. METHODS Between June 2001 and March 2007, 57 consecutive sensitized candidates donors, were treated various protocols. All patients received plasmapheresis every other day intravenous immune globulin 100 mg/kg starting 1 week before the scheduled transplant. Postoperatively, continued to receive initial week. Immunosuppression therapy consisted induction thymoglobulin combination tacrolimus, mycophenolate, corticosteroids. RESULTS Six failed convert pretransplant immunomodulation not transplanted; 51 underwent live donor Mean follow-up was 23 months 36 have more than 1-year follow-up. One-year patient graft survivals 95% 93%, respectively. There 25 episodes biopsy-proven or clinically presumed rejection in 22 first year. Of 17 episodes, 12 antibody-mediated five acute cellular rejection. (biopsy proven empiric), two (12%) lost their by The median modification diet renal disease at 6 55 mL/min (range 9-104 mL/min) 48 8-99), CONCLUSIONS Despite increased rates, indicate that is reasonable alternative who could potentially wait 10 years suitable cadaveric kidney.