transplantologiyaТрансплантологияTransplantologiya. The Russian Journal of Transplantation2074-05062542-0909IPO Association of Transplantologists10.23873/2074-0506-2011-0-2-3-48-53transplantologiya-335Research ArticleДИАГНОСТИКА И ПРОГНОЗИРОВАНИЕDIAGNOSIS AND PREDICTIONДинамика титров анти-A/B-антител в течение предоперационного кондиционирования и после AB0-несовместимой трансплантации почки от живого донораChanges of circulating anti-A/B-antibody titers during the preparation period and after AB0-incompatible living donor kidney transplantationСушковА. И.SushkovA. I.

Александр Игоревич Сушков 

sushkov.transpl@gmail.comМойсюкЯ. Г.MoisyukYa. G.ФНЦ трансплантологии и искусственных органов им. акад. В.И. ШумаковаРоссияAcademician V. I. Shumakov Federal Research Center of Transplantology and Artificial OrgansRussian Federation20112108201802-34853Copyright © Сушков А.И., Мойсюк Я.Г., 20182018Сушков А.И., Мойсюк Я.Г.Sushkov A.I., Moisyuk Y.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jtransplantologiya.ru/jour/article/view/335

Для преодоления барьера несовместимости групп крови между донором и реципиентом при трансплантации почки был разработан ряд протоколов предоперационного кондиционирования. Одной из последних была предложена комбинация антиCD20-моноклональных антител (анти-CD20), специфической иммуноадсорбции (ИА) и сывороточного иммуноглобулина (ИГ). В статье представлен анализ динамики титров анти-A/B-антител 5 пациентов в течение кондиционирования и после AB0-несовместимой трансплантации почки от живого родственного донора с использованием комбинации анти-CD20 + ИА + ИГ в качестве предтрансплантационного кондиционирования и 3-компонентной поддерживающей иммуносупрессии (такролимус + микофенолата мофетил + метилпреднизолон). Исходный титр антигрупповых антител лежал в пределах от 1:16 до 1:1024. Во всех наблюдениях удалось снизить титр анти-A/B-антител и выполнить успешную трансплантацию.

Several protocols have been developed to overcome the blood group barrier in renal transplantation. In the evolution of these protocols, one of the latest steps was the combination of anti-CD20 treatment with antigen-specific immunoadsorption (IA) and intravenous immunoglobulin (IvIg). This protocol has been widespread used for AB0-incompatible transplantation in Europe. We report our first experience of five successful AB0-incompatible kidney transplantation using anti-CD20 + IA + IvIg pretransplant conditioning protocol and tacrolimus + MMF + steroids as maintenance immunosuppression. Initial anti-A/B-antidody titers were 1:16 to 1:1024. The transplantation could be performed in all cases and the grafts showed primary function.

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The authors declare that there are no conflicts of interest present.