ABO-incompatible living donor renal transplantation began in 1982. It may provide a significant source of organs. One dose of rituximab is given four weeks pre-operatively and oral triple immunosuppressive regimen is introduced 7 days pre-operatively. Anti A/B titres are lowered to less than 1:8 by specific immunoadsorption with Glycosorb column. During the first 15 days post-transplant, accommodation state is acquired. Thereafter, graft and patient survivals, and acute humoral rejection rates are the same as those of ABO identical renal transplantations.