The development of specific desensitization regimens has significantly improved the outcome of ABO incompatible (ABOi) living donor kidney transplantation in many well-established centres across the world. In July 2023, we accomplished a milestone in the field of pediatric kidney transplant by successfully performing the first blood group incompatible transplant in an adolescent boy with hereditary cystic kidney diseases who has been on dialysis for 4 years. The donor was the mother (Blood group AB) , and the recipient was her son (Blood group A ) .
To overcome this immunological barrier, we employed the new technology of immunoadsorption instead of conventional plasma exchange, for the first time in Hong Kong. Immunoadsorption allowed more selective removal of anti-B antibodies from the recipient's blood prior to transplant, and thereby enabled the transplant to proceed with minimized risk of rejection secondary to the blood group incompatibility. The patient enjoys excellent graft function and has been clinically well.
The success of this pioneering initiative was a real- life illustration of how collaborations within and beyond Hospital Authority, and from local to international levels, help translating into clinical services to support patients in need. The feasibility of blood group incompatible transplant serves as a critical stepping stone towards increasing the availability of compatible donor organs. We are hopeful that this groundbreaking approach will pave the way for further advancements in kidney transplant, fostering a brighter future for pediatric patients in Hong Kong and beyond.
