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 0 and 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 0 and 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 last IAs | < 1:8 | BAS (20 mg at 0 and 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/kg at -1 to -5 d | < 1:4 | BAS (20 mg at 0 and 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 0 and 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 -1 to -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/kg for 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 0 and 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 last IAs | < 1:16 | BAS (20 mg at 0 and 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 0 and 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 last IAs | < 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.