Abstract
A 41 years old female patient with ESRD. She is in the waiting list for one year only, but she could not tolerate the dialysis and she had recurrent severe infections on her Jugular Permcath. At the same time the patient has multiple class I & II HLA-antibodies and considered as a highly sensitized patient who is difficult to be transplanted. All these issues caused her not only physical but various psychological difficulties as well. Only one sister of her 5 siblings was fully HLA matched to her. However, this donor has BG A while patient has BG O. Due to the difficult situation of the patient, she was prepared for the ABO incompatible RTX. At that time the Anti-A titer was 1:64 and according to our ABOi RTX protocol the isoantibody must be reduced to
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