Role of double-filtration plasmapheresis in ABO- and human leukocyte antigen-incompatible kidney transplant
Kidney transplant has significantly improved the quality of life in end-stage renal disease patients compared to maintenance hemodialysis. Recipients can receive a living-donor or a deceased-donor kidney transplant. However, the presence of donor specific anti human leukocyte antigen (HLA) antibodie...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Global Journal of Transfusion Medicine |
| Subjects: | |
| Online Access: | http://www.gjtmonline.com/article.asp?issn=2468-8398;year=2022;volume=7;issue=2;spage=209;epage=212;aulast=Sinha |
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| author | Smriti Sinha Shri Ram Kabra Saikat Mandal Vivek Bansal Tanuj Paul Bhatia Sumit More Ranjan Kumar Vibhu Ranjan Gupta |
| author_facet | Smriti Sinha Shri Ram Kabra Saikat Mandal Vivek Bansal Tanuj Paul Bhatia Sumit More Ranjan Kumar Vibhu Ranjan Gupta |
| author_sort | Smriti Sinha |
| collection | DOAJ |
| description | Kidney transplant has significantly improved the quality of life in end-stage renal disease patients compared to maintenance hemodialysis. Recipients can receive a living-donor or a deceased-donor kidney transplant. However, the presence of donor specific anti human leukocyte antigen (HLA) antibodies or anti A or B antibodies in the recipient makes the transplant incompatible and provokes to cause hyperacute, acute, or chronic rejection. Desensitization which is usually applied before to reduce incompatibility can be achieved by apheresis and preventing donor-specific antibody resynthesis by targeting both T and B cells. Here, we present two such cases transplanted successfully by desensitizing with double-filtration plasmapheresis (DFPP). Case 1 which was a female with high-titer anti-HLA antibody was managed with rituximab, 4 sessions of DFPP, antithymocyte globulin, and posttransplant Tacrolimus (Tac). Case 2 who had both high-titer anti-HLA and anti-A (IgG 1:256) antibody was managed with rituximab, 3 sessions of DFPP, and posttransplant Tac. In both cases, perioperative complications due to DFPP such as bleeding, thrombocytopenia, hypotension, and need of transfusion was minimal. These cases point toward successful application of DFPP in desensitization protocol, leading to successful HLA antibody-incompatible and ABO-incompatible renal transplant with minimal adverse incident and cost. |
| first_indexed | 2024-04-11T16:26:58Z |
| format | Article |
| id | doaj.art-632b68b5260548bd843d7e9c39c89371 |
| institution | Directory Open Access Journal |
| issn | 2468-8398 2455-8893 |
| language | English |
| last_indexed | 2024-04-11T16:26:58Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Global Journal of Transfusion Medicine |
| spelling | doaj.art-632b68b5260548bd843d7e9c39c893712022-12-22T04:14:09ZengWolters Kluwer Medknow PublicationsGlobal Journal of Transfusion Medicine2468-83982455-88932022-01-017220921210.4103/gjtm.gjtm_7_22Role of double-filtration plasmapheresis in ABO- and human leukocyte antigen-incompatible kidney transplantSmriti SinhaShri Ram KabraSaikat MandalVivek BansalTanuj Paul BhatiaSumit MoreRanjan KumarVibhu Ranjan GuptaKidney transplant has significantly improved the quality of life in end-stage renal disease patients compared to maintenance hemodialysis. Recipients can receive a living-donor or a deceased-donor kidney transplant. However, the presence of donor specific anti human leukocyte antigen (HLA) antibodies or anti A or B antibodies in the recipient makes the transplant incompatible and provokes to cause hyperacute, acute, or chronic rejection. Desensitization which is usually applied before to reduce incompatibility can be achieved by apheresis and preventing donor-specific antibody resynthesis by targeting both T and B cells. Here, we present two such cases transplanted successfully by desensitizing with double-filtration plasmapheresis (DFPP). Case 1 which was a female with high-titer anti-HLA antibody was managed with rituximab, 4 sessions of DFPP, antithymocyte globulin, and posttransplant Tacrolimus (Tac). Case 2 who had both high-titer anti-HLA and anti-A (IgG 1:256) antibody was managed with rituximab, 3 sessions of DFPP, and posttransplant Tac. In both cases, perioperative complications due to DFPP such as bleeding, thrombocytopenia, hypotension, and need of transfusion was minimal. These cases point toward successful application of DFPP in desensitization protocol, leading to successful HLA antibody-incompatible and ABO-incompatible renal transplant with minimal adverse incident and cost.http://www.gjtmonline.com/article.asp?issn=2468-8398;year=2022;volume=7;issue=2;spage=209;epage=212;aulast=Sinhadouble-filtration plasmapheresisdouble-filtration plasmapheresis in abo-incompatible kidney transplantdouble-filtration plasmapheresis in human leukocyte antigen-incompatible kidney transplant |
| spellingShingle | Smriti Sinha Shri Ram Kabra Saikat Mandal Vivek Bansal Tanuj Paul Bhatia Sumit More Ranjan Kumar Vibhu Ranjan Gupta Role of double-filtration plasmapheresis in ABO- and human leukocyte antigen-incompatible kidney transplant Global Journal of Transfusion Medicine double-filtration plasmapheresis double-filtration plasmapheresis in abo-incompatible kidney transplant double-filtration plasmapheresis in human leukocyte antigen-incompatible kidney transplant |
| title | Role of double-filtration plasmapheresis in ABO- and human leukocyte antigen-incompatible kidney transplant |
| title_full | Role of double-filtration plasmapheresis in ABO- and human leukocyte antigen-incompatible kidney transplant |
| title_fullStr | Role of double-filtration plasmapheresis in ABO- and human leukocyte antigen-incompatible kidney transplant |
| title_full_unstemmed | Role of double-filtration plasmapheresis in ABO- and human leukocyte antigen-incompatible kidney transplant |
| title_short | Role of double-filtration plasmapheresis in ABO- and human leukocyte antigen-incompatible kidney transplant |
| title_sort | role of double filtration plasmapheresis in abo and human leukocyte antigen incompatible kidney transplant |
| topic | double-filtration plasmapheresis double-filtration plasmapheresis in abo-incompatible kidney transplant double-filtration plasmapheresis in human leukocyte antigen-incompatible kidney transplant |
| url | http://www.gjtmonline.com/article.asp?issn=2468-8398;year=2022;volume=7;issue=2;spage=209;epage=212;aulast=Sinha |
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