Wednesday, August 14, 2013
Renal transplant across an
ABO barrier
Posted by Leonardo V Riella, MD, PhD
Renal Fellow Network: Renal transplant
across an ABO barrier
http://renalfellow.blogspot.com/2013/08/renal-transplant-across-abo-barrier.html?spref=tw
透析患者若有腎移植的機會，我一定是樂觀其成。近日有一位洗了約5年的女性患者，沒有肝炎或是糖尿病，很高興的跑來問我，若是她弟弟要捐腎給她，而且是同血型，可不可以？當然可以。（後來才了解，原來是她弟要去吃牢飯了，希望藉捐腎看可否慢點去關？當然，這是法律的事，不是我能插手的）
然而，我想的是，若是血型不合，就不可以腎移植嗎？剛好看到這文章，經過了移植藥物的進步，還是ABO血型不合的，還是可以有移植的機會的。「the basic idea of overcoming ABO-incompatibility is decreasing
the circulating ABO antibodies via combination of (1) antibody depletion (e.g.
plasmaphresis) (2) IVIG, (3) Rituximab or splenectomy. 」
The first ABO-incompatible
kidney transplant (ABOi KT) was performed in mid 1950s and ended up with hyperacute
rejection (HAR).
50年來，醫學果然在進步。ABOi KT (ABO-incompatible
kidney transplant) now consists of 30% of living donor KT. Nowadays, ABOi KT is
becoming a reasonable option in the US as well.
也許將來還會更高，也不一定。
台灣基層透析協會, 透析週報
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