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titers, as a sudden rise (1:32 or greater) indicates a risk for development of acute humoral rejection, and requires additional plasmapheresis treatments. Most centers also utilize protocol surveillance biopsies to further monitor for subclinical rejection. Outcomes following ABOincompatible transplantation are very good and approach that of ABOcompatible kidney transplantation. A recent study utilizing the national Scientific Registr y of Transplant Recipients (SRTR) demonstrated nearly identical patient survival rates between those receiving ABO-incompatible versus ABO-compatible kidney transplants (Montgomery, J.R., et al. Transplantation 2012; 93: 603). There were only slightly lower graft survival rates for those with ABO-incompatible transplants, with 94% of the ABO-incompatible kidneys functioning at the end of the first posttransplant year and 83% functioning at the end of the fifth post-transplant year, compared to 97% and 89%, respectively, for ABO-compatible kidney transplants. Wit h t he addition of A BOincompat ible t ra nspla nts a nd participation in KPD programs, the options for patients with willing living donors who are blood type incompatible has increased significantly. Because of the survival advantage with transplantation, these options can have a significant impact on the survival and quality of life for patients with ESRD. Dr. Kenneth Woodside is an assistant professor of surgery at Case Western Reserve University and the Director of the Living Kidney Donor Program at the Transplant Institute of University Hospitals Case Medical Center. Dr. James Schulak is a professor of surgery at Case Western Reserve University and the Director of the Transplant Institute at University Hospitals Case Medical Center. He is also the Surgical Director of the Kidney Transplant Program and Co-Director of the ABO-Incompatible Kidney Transplant Program. ■ Brouse McDowell adds value to your health care business. The health care industry constantly faces new and complex challenges. Brouse McDowell's health care law practice group proactively counsels and advises a wide array of health care clients, including multi- and single-physician groups, hospitals, health systems, ancillary service providers, long term care facilities, medical device companies and durable medical equipment and supply companies. For more information, please contact: Daniel K. Glessner, Esq., Practice Chair 330.535.5711 x316 dglessner@brouse.com or Christopher M. Huryn, Esq. 330.535.5711 x389 churyn@brouse.com Collective Experience. Collaborative Culture. Creative Solutions. Akron ■ Cleveland ■ Avon ■ www.brouse.com JULY-AUGUST 2013 ■ MDNEWS.COM ■ MD News Cleveland/Akron/Canton | 13