Thursday, June 20, 2013

HLA Antibody-Incompatible Kidney Transplantation Between Jehovah's Witnesses-A Case Report.

Desensitization before HLA antibody-incompatible (HLAi) transplantation involves nonspecific apheresis of HLA antibodies. Clotting factors and albumin are also removed and have to be replaced. This makes transplantation difficult because it increases the risk of bleeding. Such risk is further compounded when certain blood products are refused on religious grounds. We present a case of successful HLAi transplantation in a Jehovah's Witness across a positive-flow cytometric HLA crossmatch from a live donor who was also a Jehovah's Witness. This was achieved by giving rituximab 1 month before transplantation and starting prednisolone, tacrolimus, and mycophenolate mofetil 10 days before surgery. In preparation, the patient also underwent 4 sessions of double-filtration plasma exchange each followed by low-dose intravenous immunoglobulin. The night before transplantation, the fibrinogen was low, requiring 2 pools of cryoprecipitate. The organ was retrieved through laparoscopic hand-assisted retroperitoneoscopic nephrectomy and transplanted into the recipient with no complications. In addition, the patient received basiliximab during surgery. Sixteen months after transplantation the serum creatinine was 70 ╬╝mol/L (0.79 mg/dL) and there were no rejection episodes. To our knowledge this is the world's first live-related kidney transplant across the HLAi barrier between 2 Jehovah's Witnesses. This case may allow further HLAi transplants to be carried out in Jehovah's Witnesses in the future around the world (read more) Print this post

1 comment:

  1. Jehovah's Witnesses *blood transfusion confusion*.

    Jehovah's Witnesses doctrine allows a liver transplant but not the blood that is in it.

    Jehovahs Witnesses DO take blood products now in 2013.

    They take all fractions of blood.This includes hemoglobin, albumin, clotting factors, cryosupernatant and cryo-poor too, and many, many, others.
    If one adds up all the blood fractions the JWs takes, it equals a whole unit of blood. Any, many of these fractions are made from thousands upon thousands of units of donated blood.

    Jehovah’s Witnesses can take Bovine *cows blood* as long as it is euphemistically called synthetic Hemopure.
    Jehovah's Witnesses now accept every fraction of blood except the membrane of the red blood cell. JWs now accept blood transfusions.
    The fact that the JW blood issue is so unclear is downright dangerous in the emergency room.
    More than 50,000 Jehovah's Witnesses dead from Watchtowers deadly arbitrary blood ban,some estimates run as high as 100,000 dead
    Danny Haszard