Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/809
Title: Divided dosing reduces prednisolone-induced hyperglycaemia and glycaemic variability: a randomized trial after kidney transplantation.
Epworth Authors: Cohney, Solomon (Shlomo)
Other Authors: Yates, C. J.
Colman, P. C.
Fourlanos, S.
Keywords: Drug Administration Schedule
Hyperglycemia
Immunosuppressive Agents
Kidney Failure, Chronic
Prednisolone
Risk Factors
Living Donor
Antibody-Mediated Rejection
AbMR
Department of Nephrology, Epworth HealthCare, Richmond, Victoria, Australia.
UroRenal, Vascular Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Mar-2014
Publisher: Oxford
Citation: Nephrol Dial Transplant. 2014 Mar;29(3):698-705
Abstract: ABO incompatible living donor renal transplantation (ABOi) can achieve outcomes comparable to ABO compatible transplantation (ABOc). However, with the exception of blood group A2 kidneys transplanted into recipients with low titer anti-A antibody, regimens generally include antibody removal, intensified immunosuppression and splenectomy or rituximab. We now report a series of 20 successful renal transplants across a range of blood group incompatibilities using conventional immunosuppression alone in recipients with low baseline anti-blood group antibody (ABGAb) titers. Incompatibilities were A1 to O (3), A1 to B (2), A2 to O (2), AB to A (2), AB to B (1), B to A1 (9), B to O (1); titers 1:1 to 1:16 by Ortho. At 36 months, patient and graft survival are 100%. Antibody-mediated rejection (AbMR) occurred in one patient with thrombophilia and low level donor-specific anti-HLA antibody. Four patients experienced cellular rejection (two subclinical), which responded to oral prednisolone. This series demonstrates that selected patients with low titer ABGAb can undergo ABOi with standard immunosuppression alone, suggesting baseline titer as a reliable predictor of AbMR. This reduces morbidity and cost of ABOi for patients with low titer ABGAb and increases the possibility of ABOi from deceased donors.
URI: http://hdl.handle.net/11434/809
DOI: 10.1093/ndt/gft377
PubMed URL: https://www.ncbi.nlm.nih.gov/pubmed/24009292
ISSN: 0931-0509
1460-2385
Journal Title: Nephrology Dialysis Transplantation
Type: Journal Article
Affiliated Organisations: Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne, VIC, Australia
Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, VIC, Australia
Department of Nephrology, Royal Melbourne Hospital, Melbourne, VIC, Australia
Department of Medicine, NorthWest Academic Centre, University of Melbourne, St Albans, VIC, Australia
Type of Clinical Study or Trial: Crossover Design
Appears in Collections:UroRenal, Vascular

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