ABO-incompatible kidney transplantation

Purpose of review This article reviews the recent outcome of ABO-incompatible kidney transplantation and speculates on future expectations. Recent findings Pretransplant removal of anti-ABO antibodies is still necessary to prevent hyperacute rejection for patients with high titers of anti-ABO antibodies. The blood group antigen-specific immurroadsorbent, Glycosorb ABO, seems to be very promising for the selective depletion of the anti-ABO antibodies without any apparent side effects usually associated with conventional plasmapheresis. The anti-CD20 antibody, rituximab, can be used to replace splenectomy. The short-term outcome of ABO- incompatible kidney transplantation under potent immunosuppression, such as tacrolimus, mycophenolate mofetil, anti-IL2 receptor blockers, or rituximab seems to be excellent according to recent reports from some centers in the USA, Europe, and Japan. Short-term (1 -3 years) graft survival of ABO-incompatible kidney transplantation from these institutions is about 95-100%, and no serious infectious. complication has been reported. Summary Recent short-term results of ABO-incompatible kidney transplantation are excellent without any adverse events, and both potent immunosuppressive agents, such as tacrolimus, mycophenolate mofetil, or rituximab, and. immuncradsorption will greatly improve the outcome of ABO-incompatible kidney transplantation without plasmapheresis and splenectomy.