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2019, Number 3

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Rev Mex Traspl 2019; 8 (3)

ABO incompatible renal transplantation. Case report

Bahena-Carrera L, Noyola-Villalobos HF, Jiménez-Chavarría E, Loera-Torres MA, Ramírez-Salgado CU, Muñoz-Arce CM, Mora-Mendoza I, Silva-Urbano F

Language: Spanish
References: 16
Page: 100-104
PDF size: 214.24 Kb.


ABSTRACT

Introduction: 70% of kidney transplants nationwide come from living donors. In Spain and Mexico there is up to 30% incompatibility of the recipient with his donor. In Japan, ABOi kidney transplant programs were formally initiated in 1989 and later in the mid-1990s they were also established in the United States and Europe. Clinical case: A 28-year-old male with a diagnosis of chronic kidney disease secondary to chronic glomerulonephritis in 2018. The case for transplantation was accepted by transplant committee of the Central Military Hospital in April 2019. The preoperative studies were: hemoglobin 9 g/dL, leukocytes 6,870 × 103/µL, creatinine 17.4 mg/dL, urea 190 mg/dL, basal isoagglutinin titer against A of 1:16. The preconditioning therapy was with rituximab and 2 plasmapheresis sessions with post-plasmapheresis immunoglobulin application. Warm ischemia time of 27 min. The induction was with anti CD-25, tacrolimus, mycophenolic acid and steroid, the patient was discharged on the ninth day with 1.2 mg/dL creatinine, Hb 6.8 g/dL, leukocytes 7,100 × 103/µL, tacrolimus levels 6.3 ng/mL and 1:2 isoagglutinins. Posttransplant 90-day laboratories with creatinine of 1.1 mg/dL, Hb 13.9 g/dL, isoagglutinins of 1:2 and glomerular filtration rate of 90 mL/min/1.73 m2SC; he has been without surgical, medical or infectious complications.


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