TRADITIONAL AND CASCADE PLASMAPHERESIS IN ANTIBODY TITERS’ REDUCTION IN RENAL TRANSPLANT RECIPIENTS
Introduction. One of the current tasks of transplantology is to overcome «graft-host» immune confl ict. Partially this confl ict is caused by the presence of circulating pre-existing antibodies. Highly sensitized patients have a greater risk of rejection and subsequent graft loss. There are several...
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Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov
2014-05-01
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| Series: | Вестник трансплантологии и искусственных органов |
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| Online Access: | https://journal.transpl.ru/vtio/article/view/206 |
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| author | A.V. Vatazin A.B. Zulkarnayev R.O. Kantarija M. Krstich |
| author_facet | A.V. Vatazin A.B. Zulkarnayev R.O. Kantarija M. Krstich |
| author_sort | A.V. Vatazin |
| collection | DOAJ |
| description | Introduction. One of the current tasks of transplantology is to overcome «graft-host» immune confl ict. Partially this confl ict is caused by the presence of circulating pre-existing antibodies. Highly sensitized patients have a greater risk of rejection and subsequent graft loss. There are several methods to remove the antibodies, one of which is a double fi ltration plasmapheresis (DFPF). This report presents our experience of DFPF in recipients of high immunologic risk.Aim: to compare the effectiveness of traditional and double filtration plasmapheresis in desensitization of patients with high risk of immunological complications.Methods. The study included 30 patients after kidney transplantation. All patients were classifi ed as high-immunologic risk group. In 15 patients of study group we performed DFPF, in 15 patients of comparison group – traditional plasmapheresis. We monitored the immune status: markers of humoral immunity activation – IgG, IgM, IgA before and after the procedures. DFPF procedure was performed on OctoNova (MeSys, Germany) with a plasmafi lter and plasma components separator. Protocol biopsies were performed on days 30 and 90.Results. The concentration of antibodies may be effectively reduced with DFPF. Total IgM and IgG antibodies were reduced by 30–55% of the original level. There was a less albumin loss in case of DFPF application. There is 1 patient with antibody-mediated rejection with graft dysfunction in study group. There are no signs of rejection in 30- and 90-day biopsy in study group. But there were three patients with subclinical antibody-mediated rejection in the comparison group.Conclusion. DFPF can safely and effectively reduce the high titers of antibodies that are responsible for humoral rejection of renal allograft. Reduction of antibodies in sensitized patients immediately after transplantation may improve graft function. |
| format | Article |
| id | doaj-art-2bba2cecb01e4f3c9560ad91c6ecbfe9 |
| institution | DOAJ |
| issn | 1995-1191 |
| language | Russian |
| publishDate | 2014-05-01 |
| publisher | Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov |
| record_format | Article |
| series | Вестник трансплантологии и искусственных органов |
| spelling | doaj-art-2bba2cecb01e4f3c9560ad91c6ecbfe92025-08-20T03:21:06ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovВестник трансплантологии и искусственных органов1995-11912014-05-01162808710.15825/1995-1191-2014-2-80-87149TRADITIONAL AND CASCADE PLASMAPHERESIS IN ANTIBODY TITERS’ REDUCTION IN RENAL TRANSPLANT RECIPIENTSA.V. Vatazin0A.B. Zulkarnayev1R.O. Kantarija2M. Krstich3Government Budget Health Institution of Moscow region «M.F. Vladimirsky Moscow Regional Research Clinical Institute», Division of Transplantation, nephrology and surgical hemocorrection, Moscow, Russian FederationGovernment Budget Health Institution of Moscow region «M.F. Vladimirsky Moscow Regional Research Clinical Institute», Division of Transplantation, nephrology and surgical hemocorrection, Moscow, Russian FederationGovernment Budget Health Institution of Moscow region «M.F. Vladimirsky Moscow Regional Research Clinical Institute», Division of Transplantation, nephrology and surgical hemocorrection, Moscow, Russian FederationGovernment Budget Health Institution of Moscow region «M.F. Vladimirsky Moscow Regional Research Clinical Institute», Division of Transplantation, nephrology and surgical hemocorrection, Moscow, Russian FederationIntroduction. One of the current tasks of transplantology is to overcome «graft-host» immune confl ict. Partially this confl ict is caused by the presence of circulating pre-existing antibodies. Highly sensitized patients have a greater risk of rejection and subsequent graft loss. There are several methods to remove the antibodies, one of which is a double fi ltration plasmapheresis (DFPF). This report presents our experience of DFPF in recipients of high immunologic risk.Aim: to compare the effectiveness of traditional and double filtration plasmapheresis in desensitization of patients with high risk of immunological complications.Methods. The study included 30 patients after kidney transplantation. All patients were classifi ed as high-immunologic risk group. In 15 patients of study group we performed DFPF, in 15 patients of comparison group – traditional plasmapheresis. We monitored the immune status: markers of humoral immunity activation – IgG, IgM, IgA before and after the procedures. DFPF procedure was performed on OctoNova (MeSys, Germany) with a plasmafi lter and plasma components separator. Protocol biopsies were performed on days 30 and 90.Results. The concentration of antibodies may be effectively reduced with DFPF. Total IgM and IgG antibodies were reduced by 30–55% of the original level. There was a less albumin loss in case of DFPF application. There is 1 patient with antibody-mediated rejection with graft dysfunction in study group. There are no signs of rejection in 30- and 90-day biopsy in study group. But there were three patients with subclinical antibody-mediated rejection in the comparison group.Conclusion. DFPF can safely and effectively reduce the high titers of antibodies that are responsible for humoral rejection of renal allograft. Reduction of antibodies in sensitized patients immediately after transplantation may improve graft function.https://journal.transpl.ru/vtio/article/view/206cadaveric kidney allotransplantation, antibodies, immunoglobulins, plasmapheresis, cascade plasmapheresis |
| spellingShingle | A.V. Vatazin A.B. Zulkarnayev R.O. Kantarija M. Krstich TRADITIONAL AND CASCADE PLASMAPHERESIS IN ANTIBODY TITERS’ REDUCTION IN RENAL TRANSPLANT RECIPIENTS Вестник трансплантологии и искусственных органов cadaveric kidney allotransplantation, antibodies, immunoglobulins, plasmapheresis, cascade plasmapheresis |
| title | TRADITIONAL AND CASCADE PLASMAPHERESIS IN ANTIBODY TITERS’ REDUCTION IN RENAL TRANSPLANT RECIPIENTS |
| title_full | TRADITIONAL AND CASCADE PLASMAPHERESIS IN ANTIBODY TITERS’ REDUCTION IN RENAL TRANSPLANT RECIPIENTS |
| title_fullStr | TRADITIONAL AND CASCADE PLASMAPHERESIS IN ANTIBODY TITERS’ REDUCTION IN RENAL TRANSPLANT RECIPIENTS |
| title_full_unstemmed | TRADITIONAL AND CASCADE PLASMAPHERESIS IN ANTIBODY TITERS’ REDUCTION IN RENAL TRANSPLANT RECIPIENTS |
| title_short | TRADITIONAL AND CASCADE PLASMAPHERESIS IN ANTIBODY TITERS’ REDUCTION IN RENAL TRANSPLANT RECIPIENTS |
| title_sort | traditional and cascade plasmapheresis in antibody titers reduction in renal transplant recipients |
| topic | cadaveric kidney allotransplantation, antibodies, immunoglobulins, plasmapheresis, cascade plasmapheresis |
| url | https://journal.transpl.ru/vtio/article/view/206 |
| work_keys_str_mv | AT avvatazin traditionalandcascadeplasmapheresisinantibodytitersreductioninrenaltransplantrecipients AT abzulkarnayev traditionalandcascadeplasmapheresisinantibodytitersreductioninrenaltransplantrecipients AT rokantarija traditionalandcascadeplasmapheresisinantibodytitersreductioninrenaltransplantrecipients AT mkrstich traditionalandcascadeplasmapheresisinantibodytitersreductioninrenaltransplantrecipients |