| COMMENTARY |
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| Year : 2013 | Volume
: 7
| Issue : 3 | Page : 109-111 |
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Combining kidney paired donation with desensitization increases renal transplantation rate in highly sensitized patients
Vivek B Kute1, Aruna V Vanikar2, Himanshu V Patel1, Pankaj R Shah1, Manoj R Gumber1, Divyesh P Engineer1, Hargovind L Trivedi1
1 Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad 380016, Gujarat, India
2 Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad, 380016, Gujarat, India
Correspondence Address:
Vivek B Kute
Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad 380016, Gujarat
India
 Source of Support: None, Conflict of Interest: None  | 2 |
DOI: 10.1016/j.ijt.2013.05.002
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When a desensitization protocol is unsuccessful, a look-back into kidney paired donation (KPD) pool may facilitate transplantation. A 53-year male developed end stage renal disease (ESRD) due to chronic glomerulonephritis. His immunological profile remained unacceptable for transplantation with wife as potential donor even after desensitization protocol. Lymphocytotoxicity crossmatch, flow crossmatch and donor specific antibodies [DSA] were favorable for transplantation with rescue swap donor. Two-way KPD exchange was performed with steroid and rabbit anti-thymoglobulin induction under triple immunosuppressive regimen. Both recipients were discharged with stable allograft function. This case suggests that in case of an unsuccessful attempt at desensitization, rescue KPD can be used for salvaging failed desensitization treatment and increase the transplantation rate.
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