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. 2020 Jan 29;10(1):1434.
doi: 10.1038/s41598-020-58436-2.

Selective plasma exchange in ABO-incompatible kidney transplantation: comparison of substitution with albumin and partial substitution with fresh frozen plasma

Ako Hanaoka  1 , Toshihide Naganuma  2 , Daijiro Kabata  3 , Yoshiaki Takemoto  4 , Junji Uchida  4 , Tatsuya Nakatani  4 , Ayumi Shintani  3
Affiliations

Selective plasma exchange in ABO-incompatible kidney transplantation: comparison of substitution with albumin and partial substitution with fresh frozen plasma

Ako Hanaoka et al. Sci Rep. .

Abstract

We have performed selective plasma exchange (SePE) as apheresis before ABO-incompatible kidney transplantation since 2015. In this study, we divided the SePE sessions into two groups, those using albumin alone (Group A) and those partially using fresh frozen plasma (FFP) (Group F), and compared their clinical efficacies. A total of 58 sessions of SePE (Group A: n = 41, Group F: n = 17) were performed in 30 recipients of ABOi kidney transplantation during the study period and the decrease in isoagglutinin titers, changes in the levels of serum IgG and IgM as well as coagulation factors (fibrinogen, factor XIII), and incidence of side effects were retrospectively compared. There was a more significant decrease of isoagglutinin titers in Group F compared to Group A. Immunoglobulins and coagulants were replenished in Group F. Meanwhile, the incidence of side effects was significantly higher in Group F. SePE using FFP, which can effectively decrease isoagglutinins titers and replenish immunoglobulin and coagulation factors, may be a beneficial treatment modality as apheresis before ABO-incompatible kidney transplantation, in spite of a disadvantage that there are many side effects.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Selective plasma exchange circuit with hemodialysis.
Figure 2
Figure 2
Time schedule of substitution fluid administration.
Figure 3
Figure 3
Distribution of decrease in IgG antibody titers.
Figure 4
Figure 4
Distribution of decrease in IgM antibody titers.
Figure 5
Figure 5
Changes in serum IgG.
Figure 6
Figure 6
Changes in serum IgM.
Figure 7
Figure 7
Changes in fibrinogen.
Figure 8
Figure 8
Changes in factor XIII.
Figure 9
Figure 9
Comparison of incidence of side effects.
See this image and copyright information in PMC

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