ABO incompatible renal transplants: Good or bad?

Table 3 Current protocols for ABO incompatible kidney transplantation

Author	Country,year	Rituximab dose	Pretransplant IS	Antibody depletion	IVIG	Target titer at the time of transplantation	Induction IS	Maintenance IS	Posttransplant antibody depletion
Adult recipients
Rituximab protocol
Saito et al[53]	Japan,2006	375 mg/m2 (twice) at -14 and -1 d	MMF/MP at -1 mo	DFPP or PE	-	< 1:16	BAS (20 mg at 0and 4 d)	CYA/MMF/MP	-
Tyden et al[54]	Sweden, 2006	375 mg/m2 (once) at -1 mo	TAC/ MMF/Pred at -13 d	IAs	0.5 g/kg after last IAs	< 1:8	-	TAC/MMF/Pred	IAs, 3 times
Chikaraishi et al[55]	Japan,2008	100 mg/m2 (twice) at -8 and -1 d	MMF/MP at -14 d, TAC at -3 d	DFPP and PE	-	< 1:8	BAS (20 mg at 0and 4 d)	TAC/MMF/MP	-
Galliford et al[30]	United Kingdom, 2008	1000 mg (twice) at first day of PE and at the operative day	TAC/MMF at -14 d	PE	0.1 g/kg after each PE	< 1:4	DAC (2 mg/kg at 0 and 14 d)	TAC/MMF/Pred	PE at 1 and 3 d
Genberg et al[31]	Sweden, 2008	375 mg/m2 (once) at -1 mo	TAC/MMF/Pred at -10 d	IAs	0.5 g/kg at -1 d	< 1:8	-	TAC/MMF/Pred	IAs, 3 times
Oettl et al[32]	Switzerland, 2009	375 mg/m2 (once) at -1 mo	TAC/MMF /Pred at -14 d	IAs	0.5 g/kg after lastIAs	< 1:8	BAS (20 mg at 0and 4 d)	TAC/MMF/Pred	IAs or PE (not routinely)
Sivakumaran et al[78]	United States, 2009	375 mg/m2 (once) at -3 wk	MMF at -1 mo	PE	2 g/kg after last PE	NA	ALE (1 mg/kg at 0 and 14 d)	TAC/MMF/Pred	-
Wilpert et al[34]	Germany, 2010	375 mg/m2 (once) at -1 mo	TAC/MMF or MPS/Pred at -7 d	IAs	0.5 g/kgat -1 to-5 d	< 1:4	BAS (20 mg at 0and 4 d)	TAC/MMF/Pred	IAs (not routinely)
Fuchinoue et al[36]	Japan,2011	100-1000 mg, 1-3 times	CYA or TAC/MMF at -2 d	DFPP or PE	-	< 1:16	BAS (20 mg at 0and 4 d)	CYA or TAC/MMF/steroid	-
Habicht et al[37]	Germany, 2011	375 mg/m2 (once) at -1 mo	TAC/MMF/Pred at -1 mo	IAs	30 g at -1to -2 d	< 1:8	-	TAC/MMF/MP	IAs (not routinely)
Lipshutz et al[38]	United States, 2011	375 mg/m2 (once) at -1 mo	TAC/MMF at the first day of PE	PE	10 g after each PE	< 1:8	ATG (1.5 mg/kgfor 4 d)	TAC/MMF/Pred	PE (not routinely)
Shirakawa et al[39]	Japan, 2011	500 or 200 mg/m2 (once), at -5 to -7 d	TAC/MMF/MP at -7 d	DFPP	-	< 1:32	BAS (20 mg at 0and 4 d)	TAC/MMF/MP	-
Morath et al[40]	Germany, 2012	375 mg/m2 (once) at -1 mo	TAC/MMF/MP at the first day of IAs	IAs	0.5 g/kg after lastIAs	< 1:16	BAS (20 mg at 0and 4 d)	TAC/MMF/MP	IAs or PE (not routinely)
Uchida et al[41]	Japan,2012	150 mg/m2 (twice) at -14 and 0 d	MMF/MP at -1 Mo, CYA or TAC at -3 d	DFPP or PE	-	< 1:16	BAS (20 mg at 0and 4 d)	CYA or TAC/MMF/MP	-
Rituximab-free protocol
Montgomery et al[43]	United States,2009	-	TAC/MMF at the first day of PE	PE	0.1 g/kg after each PE	< 1:16	DAC (2 mg/kg initial dose, 1 mg/kg every 2 wk for total 5 doses)	TAC/MMF/Pred	PE, at least twice (with IVIG 0.1 g/kg)
Flint et al[35]	Australia, 2011	-	MMF at -10 to -14 d	PE	0.1 g/kg after each PE	< 1:8	BAS (20 mg at 0 and 4 d)	TAC/MMF/Pred	PE (not routinely)
Ashimine et al[42]	Japan,2013	-	MMF at -14 d	DFPP	-	< 1:8	BAS (20 mg at 0 and 4 d)	CYA or TAC/MMF/Pred	-
Pediatric recipients
Genberg et al[31]	Sweden, 2008	375 mg/m2 (once) at -1 mo	TAC/MMF/Pred at -10 d	IAs	0.5 g/kg at -1 d	< 1:8	-	TAC/MMF/Pred	IAs, 3 times
Tyden et al[1]	Sweden, 2011[1]	375 mg/m2 (once) at -1 mo	TAC/MMF/Pred at -13 d	IAs	0.5 g/kg after lastIAs	< 1:8	-	TAC/MMF/ Pred	IAs, 3 times

IS: Immunosuppression; IVIG: Intravenous immunoglobulin; MMF: Mycophenolate mofetil; MP: Methylprednisolone; DFPP: Double-filtration plasmapheresis; PE: Plasma exchange; BAS: Basiliximab; CYA: Cyclosporine; TAC: Tacrolimus; Pred: Prednisolone; IAs: Antigen-specific immunoadsorption; DAC: Daclizumab; NA: Not available; ALE: Alemtuzamab; MPS: Mycophenolate sodium; ATG: Antithymocyte globlin.