{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T12:30:45Z","timestamp":1759667445915},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,6,23]],"date-time":"2015-06-23T00:00:00Z","timestamp":1435017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess changes in anti\u2010blood type antibody titers and postoperative outcomes (graft survival and rejection rates) at our center with the use of the immunosuppressant, rituximab, in ABO\u2010incompatible kidney transplants from living donors. Confirming anti\u2010donor blood group antibodies is important for avoiding humoral rejection in ABO\u2010incompatible kidney transplants. Splenectomy has been carried out in our hospital according to Alexandre's policy in order to suppress the production of anti\u2010donor blood group antibodies. However, splenectomy has recently been avoided due to the administration of the immunosuppressant rituximab, which gives satisfactory outcomes. Thus, pre\u2010 and postoperative anti\u2010donor blood group antibodies were measured, and the outcomes achieved with rituximab were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 134 cases of ABO\u2010incompatible kidney transplants were carried out at Toho University Omori Medical Center between March 1989 and February 2013. These cases were classified as follows: azathioprine group (<jats:italic>n<\/jats:italic>\u00a0=\u00a062 patients); mycophenolate mofetil group (<jats:italic>n<\/jats:italic>\u00a0=\u00a033 patients); rituximab group (<jats:italic>n<\/jats:italic>\u00a0=\u00a039 patients). The anti\u2010donor blood group antibodies levels (immunoglobulin\u00a0G and immunoglobulin\u00a0M) were measured in all groups before antibody removal, immediately before surgery, and 1, 2, 4\u00a0weeks and 3\u00a0months after surgery, and then compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Rates of antibody\u2010mediated rejection, including hyperacute rejection, in the azathioprine, mycophenolate mofetil, and rituximab groups were 32.2%, 18.1% and 7.6%, respectively. Graft survival rates were higher in the mycophenolate mofetil and rituximab groups than in the azathioprine group, but were lower in patients with higher preoperative antibody titers (\u2265128\u2010fold higher immunoglobulin\u00a0G) than in those with lower titers (&lt;128\u2010fold higher immunoglobulin\u00a0G). In addition, postoperative anti\u2010blood type antibody titers were significantly suppressed in the rituximab group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Administration of rituximab results in better antibody control than previous protocols including splenectomy, even in the postoperative period during which humoral rejection often occurs. This protocol eliminates the physical invasiveness of pre\u2010transplant splenectomy, and is expected to provide better outcomes in chronic renal failure patients who undergo kidney transplants.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iju.12845","type":"journal-article","created":{"date-parts":[[2015,6,23]],"date-time":"2015-06-23T10:10:27Z","timestamp":1435054227000},"page":"931-936","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of blood group antibodies in ABO\u2010incompatible living\u2010donor kidney transplantation"],"prefix":"10.1111","volume":"22","author":[{"given":"Ken","family":"Sugiyama","sequence":"first","affiliation":[{"name":"Department of Urology Ota Memorial Hospital Gunma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoji","family":"Hyodo","sequence":"additional","affiliation":[{"name":"Department of Nephrology Toho University Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Aikawa","sequence":"additional","affiliation":[{"name":"Department of Nephrology Toho University Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,6,23]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"138","article-title":"Splenectomy as a prerequisite for successful human ABO\u2010incompatible renal transplantation","volume":"17","author":"Alexandre GPJ","year":"1985","journal-title":"Transpl. 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