Immunoadsorption in highly sensitized renal transplant recipients
Wang, W.; Liu, H.; Yin, H.; Li, X.-b.; Yang, X.-y.; Ren, L.; Hu, X.-p.; Wang, Y.; Zhang, X.-d.
Zhonghua Yi Xue Za Zhi 90(36): 2532-2535
2010
ISSN/ISBN: 0376-2491 PMID: 21092457 Document Number: 644544
To investigate the efficacy and safety of protein A immunoadsorption (IA) therapy in the prevention of highly sensitized renal transplant recipients with acute rejection. a retrospective analysis of preoperative clinical data was carried out in 12 renal transplant patients in our hospital from March 2008 to October 2009 with a high level of panel reactive antibody (PRA). Serum PRA and IgG, IgM, IgA were detected at pre and post-treatment. The acute rejection responses and adverse effects were observed. at post-treatment, PRA of both Class I and II antibody [14% (4%, 27%) vs 86% (73%, 98%), 6% (0, 23%) vs 68% (34%, 88%), P < 0.01] and serum total IgG levels significantly decreased [(550 ± 341) g/L vs (1301 ± 393) g/L, P < 0.01]. IgA and IgM were also lower than those at pre-treatment [(144 ± 78) g/L vs (185 ± 93) g/L, (103 ± 48) g/L vs (131 ± 66) g/L, P < 0.01]. Five cases had acute rejection reversible by anti-thymocyte globulin (ATG) or combined IA (n = 2). Within 6 months, 1 cases developed Aspergillus pneumonia, 2 cases of Pneumocystis carinii pneumonia were cured. IA therapy can reduce antibody levels in highly sensitized renal transplant recipients. When supplemented with induction therapy, it can effectively prevent and reduce rejection after renal transplantation.