Effect of Apheresis for ABO and HLA Desensitization on Anti-Measles Antibody Titers in Renal Transplantation

Desensitization strategies for ABO-incompatible renal transplants with plasma exchange (PE) or specific immunoadsorption (IA) decrease immunoglobulin levels. After recent measles outbreak and decreasing vaccination rates, we studied the impact of apheresis on anti-measles antibodies. Anti-measles an...

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Main Authors: Ulf Schönermarck, Teresa Kauke, Gundula Jäger, Antje Habicht, Thorsten Wendler, Joachim Andrassy, Markus Guba, Manfred Stangl, Michael Fischereder
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Journal of Transplantation
Online Access:http://dx.doi.org/10.1155/2011/869065
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author Ulf Schönermarck
Teresa Kauke
Gundula Jäger
Antje Habicht
Thorsten Wendler
Joachim Andrassy
Markus Guba
Manfred Stangl
Michael Fischereder
author_facet Ulf Schönermarck
Teresa Kauke
Gundula Jäger
Antje Habicht
Thorsten Wendler
Joachim Andrassy
Markus Guba
Manfred Stangl
Michael Fischereder
author_sort Ulf Schönermarck
collection DOAJ
description Desensitization strategies for ABO-incompatible renal transplants with plasma exchange (PE) or specific immunoadsorption (IA) decrease immunoglobulin levels. After recent measles outbreak and decreasing vaccination rates, we studied the impact of apheresis on anti-measles antibodies. Anti-measles antibodies were measured before desensitization, before transplantation and during followup in 12 patients with ABO incompatibility (2x PE only, 8x IA only, and 2x IA and PE) and 3 patients with donor-specific HLA antibodies (all PE). Patients received rituximab, IVIG, and standard immunosuppressive therapy. All patients had detectable anti-measles antibodies before desensitization (mean 3238 mU/l, range 560–8100). After 3–6 PE sessions, titers decreased significantly to 1710 mU/l (𝑃<0.05), in one patient to nondetectable values, while IA only maintained protective titers. After a median followup of 64 days, anti-measles antibodies returned to baseline in all patients. Immunity against measles was temporarily reduced by apheresis but remained detectable in most patients at time of transplantation. Desensitization maintains long-term protective immunity against measles.
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spelling doaj-art-40e452aa7acd47b79d6bf58cfaf957332025-08-20T02:07:51ZengWileyJournal of Transplantation2090-00072090-00152011-01-01201110.1155/2011/869065869065Effect of Apheresis for ABO and HLA Desensitization on Anti-Measles Antibody Titers in Renal TransplantationUlf Schönermarck0Teresa Kauke1Gundula Jäger2Antje Habicht3Thorsten Wendler4Joachim Andrassy5Markus Guba6Manfred Stangl7Michael Fischereder8Nephrology Division, Department I of Internal Medicine, University Hospital Munich—Campus Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, D-81377 Munich, GermanyLaboratory of Immunogenetics, University Hospital Munich—Grosshadern, Ludwig-Maximilians-University, Munich, GermanyDepartment of Clinical Virology, Max von Pettenkofer-Institute, Ludwig-Maximilians-University, Munich, GermanyTransplant Centre, University Hospital Munich—Grosshadern, Ludwig-Maximilians-University, Munich, GermanyNephrology Division, Department I of Internal Medicine, University Hospital Munich—Campus Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, D-81377 Munich, GermanyDepartment of Surgery, University Hospital Munich—Grosshadern, Ludwig-Maximilians-University, Munich, GermanyDepartment of Surgery, University Hospital Munich—Grosshadern, Ludwig-Maximilians-University, Munich, GermanyDepartment of Surgery, University Hospital Munich—Grosshadern, Ludwig-Maximilians-University, Munich, GermanyNephrology Division, Department I of Internal Medicine, University Hospital Munich—Campus Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, D-81377 Munich, GermanyDesensitization strategies for ABO-incompatible renal transplants with plasma exchange (PE) or specific immunoadsorption (IA) decrease immunoglobulin levels. After recent measles outbreak and decreasing vaccination rates, we studied the impact of apheresis on anti-measles antibodies. Anti-measles antibodies were measured before desensitization, before transplantation and during followup in 12 patients with ABO incompatibility (2x PE only, 8x IA only, and 2x IA and PE) and 3 patients with donor-specific HLA antibodies (all PE). Patients received rituximab, IVIG, and standard immunosuppressive therapy. All patients had detectable anti-measles antibodies before desensitization (mean 3238 mU/l, range 560–8100). After 3–6 PE sessions, titers decreased significantly to 1710 mU/l (𝑃<0.05), in one patient to nondetectable values, while IA only maintained protective titers. After a median followup of 64 days, anti-measles antibodies returned to baseline in all patients. Immunity against measles was temporarily reduced by apheresis but remained detectable in most patients at time of transplantation. Desensitization maintains long-term protective immunity against measles.http://dx.doi.org/10.1155/2011/869065
spellingShingle Ulf Schönermarck
Teresa Kauke
Gundula Jäger
Antje Habicht
Thorsten Wendler
Joachim Andrassy
Markus Guba
Manfred Stangl
Michael Fischereder
Effect of Apheresis for ABO and HLA Desensitization on Anti-Measles Antibody Titers in Renal Transplantation
Journal of Transplantation
title Effect of Apheresis for ABO and HLA Desensitization on Anti-Measles Antibody Titers in Renal Transplantation
title_full Effect of Apheresis for ABO and HLA Desensitization on Anti-Measles Antibody Titers in Renal Transplantation
title_fullStr Effect of Apheresis for ABO and HLA Desensitization on Anti-Measles Antibody Titers in Renal Transplantation
title_full_unstemmed Effect of Apheresis for ABO and HLA Desensitization on Anti-Measles Antibody Titers in Renal Transplantation
title_short Effect of Apheresis for ABO and HLA Desensitization on Anti-Measles Antibody Titers in Renal Transplantation
title_sort effect of apheresis for abo and hla desensitization on anti measles antibody titers in renal transplantation
url http://dx.doi.org/10.1155/2011/869065
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