{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T04:19:42Z","timestamp":1793074782671,"version":"4.5.0"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T00:00:00Z","timestamp":1654473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Several controversies regarding desensitization strategies for successful ABO\u2010incompatible (ABOi) kidney transplantation still exist. This study aimed to investigate whether pretransplant anti\u2010A\/B antibody removal is mandatory in an ABOi kidney transplant recipient with low baseline isoagglutinin titers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We adopted a modified desensitization protocol with two doses of rituximab (RTX, 100\u2009mg\/body) without pretransplant antibody removal for ABOi kidney transplant recipients with a titer of \u22641:64 (group A; <jats:italic>n<\/jats:italic>\u2009=\u200935) and investigated the feasibility of this protocol by comparing it with the clinical outcomes of patients undergoing standard pretransplant plasmapheresis (group B; <jats:italic>n<\/jats:italic>\u2009=\u200921).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no significant difference in the rate of antibody\u2010mediated rejection within the first month after transplantation between the two groups (11.4% in group A vs. 2% in group B, <jats:italic>p<\/jats:italic>\u2009=\u20090.6019). Moreover, no differences were observed in the short\u2010 and long\u2010term graft outcomes between the groups. However, two major critical acute antibody\u2010mediated events occurred in group A; one patient lost the graft\u00a0due to hyperacute rejection, and the other patient developed thrombotic microangiopathy after surgery. Risk factors predicting these perioperative complications were not identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We conclude that not only B\u2010cell depletion using RTX but also pretransplant antibody removal is still recommended even for patients with low isoagglutinin titers. In addition, a new diagnostic tool is needed for accurate risk stratification.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iju.14944","type":"journal-article","created":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T08:44:49Z","timestamp":1654505089000},"page":"1017-1025","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Outcome of ABO\u2010incompatible kidney transplantation using a modified desensitization protocol without plasmapheresis"],"prefix":"10.1111","volume":"29","author":[{"given":"Kazunobu","family":"Shinoda","sequence":"first","affiliation":[{"name":"Department of Nephrology Toho University Faculty of Medicine  Tokyo Japan"},{"name":"Department of Urology St. Marianna University School of Medicine  Kawasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoji","family":"Hyodo","sequence":"additional","affiliation":[{"name":"Department of Urology Dokkyo Medical University Saitama 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