In:
Journal of Clinical Apheresis, Wiley, Vol. 36, No. 1 ( 2021-02), p. 149-160
Abstract:
ABO‐incompatible (ABOi) kidney transplantation, a well‐established procedure, has good long‐term results provided pretransplant desensitization that includes immunosuppression and apheresis. Objective To compare, within the first pretransplant apheresis session given to 29 ABOi kidney‐transplant candidates, the effect on isoagglutinin titers (both IgG and IgM isotypes) of three modalities: centrifugation therapeutic plasmapheresis (cTP; n = 10), filtration TP (fTP; n = 9), and double‐filtration plasmapheresis (DFPP; n = 10). Results The three groups were comparable according to baseline demographics. Treated plasma volumes were similar across the three groups, that is, 4111 ± 403 mL (cTP), 3861 ± 282 mL (fTP), and 3699 ± 820 mL (DFPP): that is, 54 ± 7, 53 ± 7, and 53 ± 10 mL/kg respectively. One session of centrifugation or filtration TP reduced IgG anti‐A/anti‐B isoagglutinin titer by ~4, whereas one DFPP session reduced it by ~2. One session of cTP reduced IgM anti‐A isoagglutinin titer by a little less than 4, whereas fTP and DFPP sessions reduced it by ~3. There were no statistical differences across the three groups regarding isoagglutinin rebound (IgG and IgM). However, isoagglutinin IgG rebound was 〉 4 dilutions for anti‐B titers compared with ~2 dilutions for anti‐A titers. The median decreases in IgG level were −3.9 g/L (DFPP), −5.9 g/L (cTP), and − 6.06 g/L (fTP) ( p = ns). Median fibrinogen depletions were ~ 60% (fTP), 64% (DFPP), and 76% (cTP). Conclusions Isoagglutinin depletions within the first apheresis session were similar across cTP, fTP, and DFPP: this was numerically lower for DFPP.
Type of Medium:
Online Resource
ISSN:
0733-2459
,
1098-1101
Language:
English
Publisher:
Wiley
Publication Date:
2021
detail.hit.zdb_id:
2001633-5
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