ABO-incompatible kidney transplantation in Chhattisgarh - Challenges and outcome

Patients with chronic kidney disease stage 5 are usually excluded from renal transplantation if they do not have a compatible blood group donor. Paired kidney donation and ABO-incompatible kidney transplantation are the only options for such patients. We describe the case of a 49-year-old male patient who had blood Group B positive and potential donor; his wife had blood Group nagative. The patients had an initial anti-A antibody titer of 1:32 and underwent antibody depletion with plasmapheresis (two sessions). He also received rituximab 200 mg on minus 14th days and was induced with basiliximab. At the time of transplant, his anti-A titer was 1:8. Postoperatively, the patient had delayed graft function and received one session of hemodialysis but no plasmapheresis. Postoperatively, anti-A titer was 1:8. He was discharged on the 14th postoperative day with normal renal function.