1.2000
#30
SUCCESFUL KIDNEY TRANSPLANT ON A HIGHLY SENSITIZED PATIENT WITH DONOR SPECIFIC CLASS I ANTIBODY.
Anastasio Salazar, MD, Luz Stamm, BSC, Iwona Galaszkiewicz, ART, Irene Shewchuk, Charlene Ott, ART and Jane Hickerty. Calgary AB, Canada, Foothills Medical Center, T2N 2T9, Department of Surgery and Calgary AB, Canada, Calgary Laboratory Services, T2N 2T9, Tissue Typing.

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Patient with no previous transplants, no previous transfusions and six potential Living Related Donors (LRD’s), waits six years to receive a kidney transplant.
Alloimmunized by two pregnancies this patient had a specific Class I (A3) antibody to all her six LRD’s.
Cell-Cept (MMF) treatment for six months in addition to high dose IVIG allowed the laboratory to choose the best candidate with the lowest titre of antibody for the transplant. Monthly testing was performed for a period of six months with three of the six best potential donor candidates. All crossmatch results with T (CD2) and B (CD19) cells, consistently gave the same results; positive by AHG-CDC methodology.
Antibody testing was performed by Elisa (GTI) Quikscreen and the optical density was compared for each sample received. Antibody identification was performed by LCT (One Lambda) and by Elisa Quik-ID (GTI).
Transplant date was confirmed and the best donor with the lowest antibody titre was chosen for the transplant. High dose IVIG treatment was given to the patient for three consecutive days previous to the day of the transplant. Crossmatch was performed the day before the transplant and results remained weakly positive. One plasmapheresis treatment was given the morning of the transplant and a sample was tested again obtaining a negative crossmatch result with T (CD2) and B (CD19) cells.
Post monitoring testing was followed after transplantation.
Three months later the patient has a creatinine of 82 and is living a normal life.