{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T14:16:03Z","timestamp":1762956963045,"version":"3.41.2"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T00:00:00Z","timestamp":1658016000000},"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":["Pediatric Transplantation"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>HLA sensitization is a growing problem in children awaiting kidney transplantation. In some cases, finding an immunologically compatible donor entails contemplating the option of an ABO incompatible transplant or paired transplant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patient with genetic nephrotic syndrome and progressive chronic kidney disease, with a previous thrombosis of a first kidney transplant, resulting hypersensitized and remaining for a long\u2010time on hemodialysis. Despite a desensitization strategy, family members were incompatible and deceased donation options must be ruled out due to the presentation of donor\u2010specific antibodies (DSA). After 4\u2009years, the possibility arises to perform a kidney paired transplant with a 62\u2010year\u2010old woman with an incompatible blood group. Although the current cytotoxicity\u2010 and cell\u2010based crossmatches were negative, history of DSA were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>An intensive ABO and HLA desensitization protocol was performed in order to combat the isohemagglutinin antibodies and on the memory\u2010HLA, based on rituximab, apheresis sessions, and immunoglobulins. Despite the donor being older in terms of pediatric transplantation, the donor\u2010recipient weight difference, and immunological risk, the transplant was completed successfully. Maintenance of titration of up to 1\/2 was confirmed after 3\u2009weeks post\u2010transplant (IgM and IgG). Kidney biopsy at 2\u2009weeks and 6\u2009months without signs of rejection. The patient is currently 12\u2009months post\u2010transplant and has not presented any signs of transplant rejection and has proper renal function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Kidney paired transplantation is an excellent solution for hypersensitized children, and ABO incompatibility can be considered to increase their options to find a good donor, without thereby obtaining worse results.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14359","type":"journal-article","created":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T18:30:14Z","timestamp":1658082614000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Overcoming limits: First ABO incompatible living donor paired kidney transplant in an hypersensitized pediatric recipient in Spain"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0635-4200","authenticated-orcid":false,"given":"Yolanda","family":"Calzada","sequence":"first","affiliation":[{"name":"Pediatric Nephrology and Renal Transplant Department Hospital Sant Joan de D\u00e9u  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3584-4516","authenticated-orcid":false,"given":"Ignacio","family":"Revuelta","sequence":"additional","affiliation":[{"name":"Nephrology and Renal Transplant Department Hospital Cl\u00ednic  Barcelona Spain"},{"name":"Laboratori Experimental de Nefrologia i Trasplantament (LENIT) Institut d'Investigacions, Biom\u00e8diques August Pi i Sunyer (IDIBAPS)  Barcelona Spain"},{"name":"Department of Medicine University of Barcelona  Barcelona Spain"},{"name":"Red de Investigaci\u00f3n Renal (REDINREN)  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0989-5635","authenticated-orcid":false,"given":"Elena","family":"Codina","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology and Renal Transplant Department Hospital Sant Joan de D\u00e9u  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2612-5250","authenticated-orcid":false,"given":"Antonio","family":"Alcaraz","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Clinic Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2535-0205","authenticated-orcid":false,"given":"V\u00edctor","family":"L\u00f3pez\u2010B\u00e1ez","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology and Renal Transplant Department Hospital Sant Joan de D\u00e9u  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9740-4439","authenticated-orcid":false,"given":"David","family":"Paredes","sequence":"additional","affiliation":[{"name":"Donation and Transplant Coordination Section Hospital Clinic Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2407-5667","authenticated-orcid":false,"given":"Pedro","family":"Arango","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology and Renal Transplant Department Hospital Sant Joan de D\u00e9u  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1544-1485","authenticated-orcid":false,"given":"Eduard","family":"Palou","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Barcelona  Barcelona Spain"},{"name":"Department of Immunology Hospital Clinic de Barcelona  Barcelona 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