{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T17:09:32Z","timestamp":1766336972309,"version":"3.48.0"},"reference-count":14,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"vor","delay-in-days":8,"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":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>End\u2010stage renal disease (ESRD) is a critical global health concern, with kidney transplantation being the preferred treatment for children with stage 5 chronic kidney disease. However, ABO\u2010incompatibility (ABOi) poses a major barrier to successful transplantation. While advances in antibody removal techniques, including immunoadsorption (IA), have enabled ABOi kidney transplantation, cost remains a significant challenge, especially in low\u2010resource settings. Most available data focus on adults, with limited pediatric reports, particularly using reusable IA columns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>We report the case of a 7\u2010year\u2010old girl who underwent ABOi kidney transplantation from her mother, despite an exceptionally high pretransplant anti\u2010B IgG antibody titer of 1:1\u2009024. She received a single dose of Rituximab (200\u2009mg) 14\u2009days pretransplant, followed by two IA sessions using a reusable Vitrosorb IA column. The first session reduced titers to 1:16, but a rebound increase to 1:128 necessitated a second session, bringing titers down to 1:8. A final plasmapheresis session stabilized titers before transplantation. The surgery was uneventful, and post\u2010transplant antibody levels remained controlled. The patient demonstrated good graft function and was discharged in stable condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion &amp; Conclusion<\/jats:title>\n                    <jats:p>This is the highest reported pretransplant titer (1:1\u2009024) in a pediatric ABOi kidney transplant case. The use of a reusable Vitrosorb IA column proved both effective and cost\u2010efficient, making it a viable option in resource\u2010limited settings. Our findings suggest that IA reuse is safe, reduces financial burden, and warrants further investigation for broader clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70238","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T04:35:36Z","timestamp":1765341336000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Successful Pediatric\n                    <scp>ABO<\/scp>\n                    Incompatible Transplant Using Reusable Vitrosorb Column"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0999-9864","authenticated-orcid":false,"given":"Akash","family":"Gupta","sequence":"first","affiliation":[{"name":"Nephrology and Kidney Transplant Fortis Escorts Heart Institute  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1778-7693","authenticated-orcid":false,"given":"Sanjeev","family":"Gulati","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplant Fortis Escorts Heart Institute  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9844-5967","authenticated-orcid":false,"given":"Ajit Singh","family":"Narula","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplant Fortis Escorts Heart Institute  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2169-6115","authenticated-orcid":false,"given":"Paresh","family":"Jain","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplant Fortis Escorts Heart Institute  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.15171\/jnp.2016.17"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199912023412303"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.5500\/wjt.v4.i1.18"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13138"},{"issue":"1","key":"e_1_2_6_6_1","first-page":"161","article-title":"ABO\u2010Incompatible Kidney Transplantation in Children","volume":"27","author":"Yamazaki Y.","year":"1995","journal-title":"Transplantation Proceedings"},{"issue":"2","key":"e_1_2_6_7_1","first-page":"253","article-title":"Therapeutic Plasma Exchange Reduces ABO Antibody Titer in Incompatible Kidney Transplantation","volume":"50","author":"Tobian A. A. R.","year":"2010","journal-title":"Transfusion"},{"issue":"7","key":"e_1_2_6_8_1","first-page":"1011","article-title":"ABO\u2010Incompatible Kidney Transplantation Using Both Antigen\u2010Specific Immunoadsorption and Rituximab: A Pilot Study","volume":"4","author":"Gloor J. M.","year":"2004","journal-title":"American Journal of Transplantation"},{"issue":"3","key":"e_1_2_6_9_1","first-page":"781","article-title":"The Stockholm Experience With ABO\u2010Incompatible Kidney Transplantation Without Splenectomy","volume":"39","author":"Tyd\u00e9n G.","year":"2007","journal-title":"Transplantation Proceedings"},{"issue":"4","key":"e_1_2_6_10_1","first-page":"1091","article-title":"Outcomes of ABO\u2010Incompatible Kidney Transplantation in Japan: The Role of Antibody Management","volume":"50","author":"Japanese ABO\u2010Incompatible Kidney Transplantation Registry","year":"2018","journal-title":"Transplantation Proceedings"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000078622.43689.D4"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181726849"},{"key":"e_1_2_6_13_1","first-page":"234","article-title":"Three\u2010Year Graft Survival Rates in 1,420 ABO\u2010Incompatible Kidney Transplants: Registry Analysis From 2001\u20102010","volume":"8","author":"Scandinavian Registry Study","year":"2015","journal-title":"Frontiers in Immunology"},{"issue":"8","key":"e_1_2_6_14_1","doi-asserted-by":"crossref","first-page":"3286","DOI":"10.1016\/j.transproceed.2005.09.002","article-title":"ABO\u2010Incompatible Kidney Transplantation Using Antigen\u2010Specific Immunoadsorption and Rituximab: A 3\u2010Year Follow\u2010Up","volume":"37","author":"Tyd\u00e9n G.","year":"2005","journal-title":"Transplantation Proceedings"},{"key":"e_1_2_6_15_1","first-page":"52","article-title":"Immunoadsorption in Highly Sensitized Patients: Efficacy and Challenges","volume":"44","author":"Schr\u00f6der P. M.","year":"2017","journal-title":"Transplant Immunology"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70238","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T17:07:13Z","timestamp":1766336833000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.70238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":14,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/petr.70238"],"URL":"https:\/\/doi.org\/10.1111\/petr.70238","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"type":"print","value":"1397-3142"},{"type":"electronic","value":"1399-3046"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"2025-02-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70238"}}