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Overcoming antibodiesOvercoming antibodiesbarriers in renal transplantbarriers in renal transplant
Hanan FathyHanan FathyAssistant lecturerAssistant lecturerPediatric Nephrology DepartmentPediatric Nephrology DepartmentAlexandria UniversityAlexandria University
 
 
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 The shortage of donor organs, especially in The shortage of donor organs, especially inrenal transplantation, leads to an increasingrenal transplantation, leads to an increasingdiscrepancy between the number of end-stagediscrepancy between the number of end-stagerenal disease patients on waiting lists and therenal disease patients on waiting lists and thenumber of available deceased donor kidneys.number of available deceased donor kidneys.
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Expansion of the donor pool can be achieved byExpansion of the donor pool can be achieved byincreasing the numbers of living kidneyincreasing the numbers of living kidneytransplantation and by overcoming thetransplantation and by overcoming theimmunological barriers of ABO-incompatibilityimmunological barriers of ABO-incompatibilityand HLA-sensitization.and HLA-sensitization.
 
 
HISTORY HISTORY 
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Attempts to overcome barriers to kidney transplantsAttempts to overcome barriers to kidney transplantsare not new. In the 1980s some patients wereare not new. In the 1980s some patients weresuccessfully transplanted following plasmapheresis,successfully transplanted following plasmapheresis,But it was not embraced by the transplantBut it was not embraced by the transplantcommunity because it was expensive.community because it was expensive.
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In Japan, however, where deceased donor kidneyIn Japan, however, where deceased donor kidneytransplantation is unpopular, scientists saw thetransplantation is unpopular, scientists saw theprocedure as the only way to save many lives.procedure as the only way to save many lives.
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In 1998, they surprised the transplant communityIn 1998, they surprised the transplant communitywhen they reported an eight-year follow-up study onwhen they reported an eight-year follow-up study on61 patients who had had ABO incompatible61 patients who had had ABO incompatibletransplantstransplants
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