Overcoming antibody barriers to transplantation: ABO-incompatible and positive cross-match kidney transplantation at Mayo Clinic – Rochester

Over the past several years, protocols have been developed to allow patients with antibody against either donor blood group (ABO-incompatible) or donor HLA antigens (positive cross-match) to undergo successful kidney transplantation. Important factors determining the development of hyperacute rejection, humoral rejection and long-term graft survival have been defined. In this review, the clinical experience with ABO-incompatible and positive cross-match kidney transplantation at Mayo Clinic, Rochester are described with an emphasis on both patient management issues and gaps in our current knowledge in this emerging field.