Changes of circulating anti-A/B-antibody titers during the preparation period and after AB0-incompatible living donor kidney transplantation

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.