|
| | Pretransplant desensitization | Acceptable final titer | Posttransplant desensitization |
Posttrans-
plant monitoring | Splenectomy |
| Ab depletion | IVIG | Rituximab | IS drug | Ab depletion | IVIG | Rituximab | IS drug | | |
|
| Montgomery, 1st era (Johns Hopkins) | PP or IA | Low dose* (0.1 g/kg): CMV-IVIG | No: if high risk, single dose at POD# −1 | FK/MMF: start at the beginning of PP | <1 : 16 | PP or IA | Low dose (0.1 g/kg): CMV-IVIG | No | Daclizumab: initial 2 mg/kg, and then 1 mg/kr q 2 wks for 5-dose FK/MMF/MPD | Anti-ABO IgG titer: weekly for POD# 1 mon at POD# 2, 3, 6, 12 mon | No
(work as rescue therapy for ABMR) |
|
| Tyden (Stockholm) | IA: at POD# −6, −5, −4, −1 | Standard dose (0.5 g/kg): single dose at POD# −1 | Yes (375 mg/m2): single dose at POD# −10 | FK/MMF/MPD (high dosage): start at POD# −10 | <1 : 8 | IA: preemptive 3 times at each 3 days | No | No | FK/MMF/MPD | Anti-ABO IgG titer | No |
|
| Genberg (Stockholm) | IA | Standard dose (0.5 g/kg): single dose at POD# −1 | Yes (375 mg/m2): single dose at POD# −30 | FK/MMF/MPD (high dosage): start at POD# −10 | no | IA: preemptive 3 times | Low dose (0.5 g/kg): 5 doses | No: If high B cell count, add dose | FK/MMF/MPD | B-cell count measurement at posttransplant 6 month | No |
|
| Wilpert (Germany) | IA | Standard dose (0.5 g/kg): single dose at POD# −5 ~ −1 | Yes (375 mg/m2): single dose at POD# −30 | FK/MMF/MPD: start at POD# −7 | ≤1 : 4 | IA | No | No | basiliximab FK/MMF/MPD | Anti-ABO IgG titer: ≥1 : 8 in 1st week and ≥1 : 16 in 2nd week | No |
|
| Flint (Australia) | TPE | Low dose* (0.1 g/kg): but, 0.5 g/kg at POD# −1 | No | MMF: start at POD# −10 | ≤1 : 8 | TPE | Low dose (0.1 g/kg) | No | basiliximab FK/MMF/MPD | Anti-ABO IgG titer: daily for the first 2 weeks and then, twice a week for the first 2 months | No
(work as rescue therapy for ABMR) |
|
| Gloor (Mayo) | TPE | Low dose* (0.1 g/kg) | Yes (375 mg/m2): 2 doses at the starting of PP | MMF | ≤1 : 8 | No | No | No | ATGAM FK/MMF/MPD | | No |
|
| Oettl (Basel) | IA (daily) | Standard dose (0.5 g/kg): single doseat POD# −1 | Yes (375 mg/m2): single dose at POD# −30 | FK/MMF/MPD: start at POD# −14 | ≤1 : 8
(IgM, IgG) | IA | No | No | basiliximab FK/MMF/MPD | Anti-AB IgM or IgG titer ≥1 : 8 | No |
|
| Tanabe (Tokyo) | DFPP: start at POD# −7 | No | Yes (200 mg/m2): single dose | FK/MMF/MPD: start at POD# −7 | ≤1 : 32 | No | No | No | basiliximab FK/MMF/MPD | No | Yes (selectively) |
|
| Montgomery, 2nd era (Johns-Hpokins) | PP | Low dose* (0.1 g/kg): CMV-IVIG | No | FK/MMF: start at the beginning of PP | ≤1 : 16 | PP: preemptive 2 times | Low dose (0.1 g/kg): CMV-IVIG | No | daclizumab FK/MMF/MPD | Anti-ABO IgG titer >1 : 32 (If so, protocol biopsy) | No |
|
| Galliford (UK) | PP: start at POD# −14 | Low dose* (0.1 g/kg) | Yes (1 g): 2 dose at the starting of PP | FK/MMF: start at the beginning of PP | ≤1 : 4 | PP: at POD# 1, 3 | Low dose (0.1 g/kg): 2 times routinely | Yes (1 g): at POD# 0 (posttra-
nsplant) | daclizumab FK/MMF/MPD (steroid-sparing protocol) | Anti-ABO IgG titer | No |
|
| Uchida (Osaka) | DFPP or TPE | No | Yes (150 mg/m2): 2 dose at POD# −14, −1 | FK: start at POD# −3 MMF/MPD: start at POD# −30 | ≤1 : 16 | No | No | No | basiliximab FK/MMF/MPD | No | Yes |
|
