臨床検査52巻7号

2008年07月発行

今月の主題 腎移植 総説

ABO血液型不適合腎移植の新しい展開

著者： 高橋公太¹

所属機関： ¹新潟大学大学院医歯学総合研究科腎泌尿器病態学分野

ページ範囲：P.741 - P.748

　わが国では，欧米諸国に比べて献腎の提供が極めて少ないため，腎移植の適応を拡大する目的で20年前からABO血液型不適合腎移植が開始された．その治療戦略の進歩により適合腎移植の成績と遜色なくなり，わが国はもちろんのこと世界的に普及している．今回は，最近のABO血液型不適合腎移植の現状と成績が向上した要因について述べたい．

参考文献

１) Alexandre GPJ, Bruyere MDE, Squifflet JP, et al：ABO incompatible living donor renal homografts. Neth J Med　28：231-234, 1985

２) Takahashi K, Saito K, Takahara S, et al：The Japanese ABO-incompatible Kideny Transplantation Committee. Excellent long-term outcome of ABO-incompatible living donor kidney transplantation in Japan. Am J Transplant　4：1089-1096, 2004

３) Takahashi K, Saito K：The Japanese ABO-incompatible Kidney Transplantation Committee. Present status of ABO-incompatible kidney transplantation in Japan. Xenotransplantation　13：118-122, 2006

４) Takahashi K：ABO-incompatible organ transplantation. Curr Opin Organ Transplant　12：409-414, 2007

５) 高橋公太：わが国のABO血液型不適合腎移植の統計，第11回アンケート調査報告．今日の移植　20：552-564, 2007

６) Takahashi K：Accommodation in ABO-incompatible kidney transplantation：Why do kidney grafts survive? Transplant Proc　36(Suppl 2S)：193-196, 2004

７) Takahashi K：Accommodation in ABO-incompatible Kidney Transplantation, Elsevier, Amsterdam, pp1-209, 2004

８) Takahashi K：A new concept of accommodation in ABO-incompatible kidney transplantation. Clin Transplant　19(Suppl 14)：76-85, 2005

９) Takahashi K：ABO-incompatible kidney transplantation-Establishing a Scientific Framework, Elsevier, Amsterdam, pp1-93, 2007

10) Takahashi K：A review of humoral rejection in ABO-incompatible kidney transplantation with local(intrarenal)DIC as the underlying condition. Acta Med Biol　45：95-102, 1997

11) Takahashi K：Recent findings in ABO-incompatible kidney transplantation-classification and therapeutic strategy for acute antibody-mediated rejection due to ABO-blood-group-related antigens during critical period preceding establishment of accommodation. Clin Exp Nephrol　11：128-141, 2007

12) Nishi S, Hasegawa S, Takahashi K, et al：The safety measures for double filtration plasmaphereis(DFPP)before ABO incompatible kidney transplantation. In：ABO-incompatible Organ Transplantation from Japan(Takahsahi K, Ed), Elsevier, Amsterdam, pp91-95, 2006

13) Rydlerg L, Bengtsson A, Nilsson K, et al：In vitro assessment of a new ABO immunosorbent with synthetic carbohydrates attached to sepharose. Transplant Int　17：666-672, 2005

14) Tyden G, Kumlien G, Fehrman I：Successful ABO-incompatible kidney transplantations without splenectomy using antigen-specific immunoadsorption and rituximab. Transplantation　76：730-743, 2003

15) Takahashi K：Immunosuppressive therapy. In：Accommodation in ABO-incompatible Kidney Transplantation, Elsevier, Amsterdam, pp53-66, 2004

16) Takahashi K：Timing of the start of immunosuppressive therapy(duration of desensitization therapy). In：Accommodation in ABO-incompatible Kidney Transplantation, Amsterdam, Elsevier, pp94-95, 2004

17) Saito K, Nakagawa Y, Takahashi K, et al：Pinpoint targeted immunosuppression；Anti-CD20/MMF desensitization with anti-CD25 in successful ABO-incompatible kidney transplantation without splenectomy. Xenotransplantation　13：111-117, 2006

18) Takahashi K：A new immunosuppressive therapy in ABO-incompatible kidney transplantation based on a new concept of accommodation. In：ABO-incompatible Organ Transplantation from Japan(Takahashi K, Ed), Elsevier, Amsterdam, pp73-87, 2006

19) Alexandre GPJ, Squifflet JP, DeBruyere M, et al：Splenectomy as a prerequisite for successful human ABO-incompatible renal transplantation. Transplant Proc　17：138-143, 1985

20) Takahashi K：Effects and complications of splenectomy. In：Accommodation in ABO-incompatible kidney transplantation, Elsevier, Amsterdam, pp81-83, 2004