Efficacy of a negative conversion trial and subsequent living donor kidney transplant outcome in recipients with a positive lymphocyte crossmatch

Kyu Ha Huh, Soon Il Kim, Dong Jin Joo, Man Ki Ju, Hye Kyung Chang, Hae Jin Kim, YuSeun Kim, Myoung Soo Kim

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Patients with a positive lymphocyte crossmatch (LCX) do not undergo kidney transplantation. In such patients, a negative conversion protocol consisting of intravenous immunoglobulin (IVIG), plasmapheresis, and potent immunosuppressant is one of the options for transplantation. Methods: 14 patients who showed a positive LCX with living donors underwent a trial of negative conversion between January 2002 and July 2007. Plasmapheresis was performed every other day, up to 6 times maximum. IVIG was infused after plasmapheresis, with a total dose of 500 mg/kg divided over 6 days. Kidney transplantation was performed immediately after negative conversion. Anti-thymocyte globulin (ATG) or OKT3 induction therapy was used with the combination of tacrolimus, mycophenolate mofetil, and prednisone in the perioperative period. Results: Negative conversion of LCX was achieved in 13 of 14 patients (92.9%). Transplantations were performed successfully in these 13 patients without hyperacute rejection. Four recipients developed acute rejection, which was well controlled by steroid pulse therapy. During the follow-up periods of 45.4 ± 22.0 months, all recipients except 1 showed excellent graft function. Conclusion: Selected patients with a positive LCX can undergo successful transplantation using plasmapheresis, IVIG, and potent immunosuppressants. Recipients with negative conversion of LCX showed acceptable posttransplant results.

Original languageEnglish
JournalNephron - Clinical Practice
Volume111
Issue number1
DOIs
Publication statusPublished - 2009 Jan 1

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Living Donors
Plasmapheresis
Lymphocytes
Transplants
Kidney
Intravenous Immunoglobulins
Transplantation
Immunosuppressive Agents
Kidney Transplantation
Mycophenolic Acid
Muromonab-CD3
Perioperative Period
Antilymphocyte Serum
Tacrolimus
Prednisone
Steroids
Therapeutics

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Huh, Kyu Ha ; Kim, Soon Il ; Joo, Dong Jin ; Ju, Man Ki ; Chang, Hye Kyung ; Kim, Hae Jin ; Kim, YuSeun ; Kim, Myoung Soo. / Efficacy of a negative conversion trial and subsequent living donor kidney transplant outcome in recipients with a positive lymphocyte crossmatch. In: Nephron - Clinical Practice. 2009 ; Vol. 111, No. 1.
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abstract = "Background: Patients with a positive lymphocyte crossmatch (LCX) do not undergo kidney transplantation. In such patients, a negative conversion protocol consisting of intravenous immunoglobulin (IVIG), plasmapheresis, and potent immunosuppressant is one of the options for transplantation. Methods: 14 patients who showed a positive LCX with living donors underwent a trial of negative conversion between January 2002 and July 2007. Plasmapheresis was performed every other day, up to 6 times maximum. IVIG was infused after plasmapheresis, with a total dose of 500 mg/kg divided over 6 days. Kidney transplantation was performed immediately after negative conversion. Anti-thymocyte globulin (ATG) or OKT3 induction therapy was used with the combination of tacrolimus, mycophenolate mofetil, and prednisone in the perioperative period. Results: Negative conversion of LCX was achieved in 13 of 14 patients (92.9{\%}). Transplantations were performed successfully in these 13 patients without hyperacute rejection. Four recipients developed acute rejection, which was well controlled by steroid pulse therapy. During the follow-up periods of 45.4 ± 22.0 months, all recipients except 1 showed excellent graft function. Conclusion: Selected patients with a positive LCX can undergo successful transplantation using plasmapheresis, IVIG, and potent immunosuppressants. Recipients with negative conversion of LCX showed acceptable posttransplant results.",
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Efficacy of a negative conversion trial and subsequent living donor kidney transplant outcome in recipients with a positive lymphocyte crossmatch. / Huh, Kyu Ha; Kim, Soon Il; Joo, Dong Jin; Ju, Man Ki; Chang, Hye Kyung; Kim, Hae Jin; Kim, YuSeun; Kim, Myoung Soo.

In: Nephron - Clinical Practice, Vol. 111, No. 1, 01.01.2009.

Research output: Contribution to journalArticle

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T1 - Efficacy of a negative conversion trial and subsequent living donor kidney transplant outcome in recipients with a positive lymphocyte crossmatch

AU - Huh, Kyu Ha

AU - Kim, Soon Il

AU - Joo, Dong Jin

AU - Ju, Man Ki

AU - Chang, Hye Kyung

AU - Kim, Hae Jin

AU - Kim, YuSeun

AU - Kim, Myoung Soo

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N2 - Background: Patients with a positive lymphocyte crossmatch (LCX) do not undergo kidney transplantation. In such patients, a negative conversion protocol consisting of intravenous immunoglobulin (IVIG), plasmapheresis, and potent immunosuppressant is one of the options for transplantation. Methods: 14 patients who showed a positive LCX with living donors underwent a trial of negative conversion between January 2002 and July 2007. Plasmapheresis was performed every other day, up to 6 times maximum. IVIG was infused after plasmapheresis, with a total dose of 500 mg/kg divided over 6 days. Kidney transplantation was performed immediately after negative conversion. Anti-thymocyte globulin (ATG) or OKT3 induction therapy was used with the combination of tacrolimus, mycophenolate mofetil, and prednisone in the perioperative period. Results: Negative conversion of LCX was achieved in 13 of 14 patients (92.9%). Transplantations were performed successfully in these 13 patients without hyperacute rejection. Four recipients developed acute rejection, which was well controlled by steroid pulse therapy. During the follow-up periods of 45.4 ± 22.0 months, all recipients except 1 showed excellent graft function. Conclusion: Selected patients with a positive LCX can undergo successful transplantation using plasmapheresis, IVIG, and potent immunosuppressants. Recipients with negative conversion of LCX showed acceptable posttransplant results.

AB - Background: Patients with a positive lymphocyte crossmatch (LCX) do not undergo kidney transplantation. In such patients, a negative conversion protocol consisting of intravenous immunoglobulin (IVIG), plasmapheresis, and potent immunosuppressant is one of the options for transplantation. Methods: 14 patients who showed a positive LCX with living donors underwent a trial of negative conversion between January 2002 and July 2007. Plasmapheresis was performed every other day, up to 6 times maximum. IVIG was infused after plasmapheresis, with a total dose of 500 mg/kg divided over 6 days. Kidney transplantation was performed immediately after negative conversion. Anti-thymocyte globulin (ATG) or OKT3 induction therapy was used with the combination of tacrolimus, mycophenolate mofetil, and prednisone in the perioperative period. Results: Negative conversion of LCX was achieved in 13 of 14 patients (92.9%). Transplantations were performed successfully in these 13 patients without hyperacute rejection. Four recipients developed acute rejection, which was well controlled by steroid pulse therapy. During the follow-up periods of 45.4 ± 22.0 months, all recipients except 1 showed excellent graft function. Conclusion: Selected patients with a positive LCX can undergo successful transplantation using plasmapheresis, IVIG, and potent immunosuppressants. Recipients with negative conversion of LCX showed acceptable posttransplant results.

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