AB0 incompatible kidney transplantation using unspecific immunoadsorption

Abstract Background A protocol for ABO-incompatible kidney transplantation with antigen specific immunoadsorption, rituximab and conventional immunosuppression has been successfully implemented in many European centers. We report an alternative method for the elimination of isoagglutinins with a num...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Transfusion and apheresis science 2014-04, Vol.50 (2), p.263-266
Hauptverfasser: Hickstein, Heiko, Koball, Sebastian, Lehmann, Renate, Protzel, Chris, Stein, Kathrin, Mitzner, Steffen, Hakenberg, Oliver
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Abstract Background A protocol for ABO-incompatible kidney transplantation with antigen specific immunoadsorption, rituximab and conventional immunosuppression has been successfully implemented in many European centers. We report an alternative method for the elimination of isoagglutinins with a number of advantages – large amount of treatable plasma, parallel removal of other rejection-inducing antibodies, long operating life, favorable cost-benefit ratio. Method We report our first successfully treated case of an ABO-incompatible living donor kidney transplantation using Immunoadsorption with Ig-TheraSorb®. We performed 5 sessions preoperatively and one after transplantation. Per treatment session twice the calculated plasma volume (4400 ml in this patient) was treated. Results Per treatment session the IgM- isoagglutinin-titers were reduced from 1:16 to 1:1 and the IgG- isoagglutinin-titers from 1:32 to 1:2. There were no side effects and the procedure was well tolerated with good renal function 500 days post transplantation. Conclusion Ig-TheraSorb®-Immunoadsorption is an alternative method of elimination of harmful antibodies and it enables successful integration of ABO-incompatible transplantation into regular transplantation programs.
ISSN:1473-0502
1878-1683
DOI:10.1016/j.transci.2014.01.006