Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb;36(1):149-160.
doi: 10.1002/jca.21857. Epub 2020 Nov 23.

Isoagglutinin removal by plasma centrifugation or filtration (single or double): A prospective study in a single center

Hamza Naciri Bennani  1 , Johan Noble  1 , Eloi Chevallier  1 , Florian Terrec  1 , Lionel Motte  1 , Claudine Giroux-Lathuile  2 , Mathilde Bugnazet  1 , Farida Imerzoukene  1 , Bénédicte Janbon  1 , Paolo Malvezzi  1 , Lionel Rostaing  1   3 , Thomas Jouve  1   3
Affiliations

Isoagglutinin removal by plasma centrifugation or filtration (single or double): A prospective study in a single center

Hamza Naciri Bennani et al. J Clin Apher. 2021 Feb.

Abstract

Introduction: ABO-incompatible (ABOi) kidney transplantation, a well-established procedure, has good long-term results provided pretransplant desensitization that includes immunosuppression and apheresis.

Objective: To compare, within the first pretransplant apheresis session given to 29 ABOi kidney-transplant candidates, the effect on isoagglutinin titers (both IgG and IgM isotypes) of three modalities: centrifugation therapeutic plasmapheresis (cTP; n = 10), filtration TP (fTP; n = 9), and double-filtration plasmapheresis (DFPP; n = 10).

Results: The three groups were comparable according to baseline demographics. Treated plasma volumes were similar across the three groups, that is, 4111 ± 403 mL (cTP), 3861 ± 282 mL (fTP), and 3699 ± 820 mL (DFPP): that is, 54 ± 7, 53 ± 7, and 53 ± 10 mL/kg respectively. One session of centrifugation or filtration TP reduced IgG anti-A/anti-B isoagglutinin titer by ~4, whereas one DFPP session reduced it by ~2. One session of cTP reduced IgM anti-A isoagglutinin titer by a little less than 4, whereas fTP and DFPP sessions reduced it by ~3. There were no statistical differences across the three groups regarding isoagglutinin rebound (IgG and IgM). However, isoagglutinin IgG rebound was >4 dilutions for anti-B titers compared with ~2 dilutions for anti-A titers. The median decreases in IgG level were -3.9 g/L (DFPP), -5.9 g/L (cTP), and - 6.06 g/L (fTP) (p = ns). Median fibrinogen depletions were ~ 60% (fTP), 64% (DFPP), and 76% (cTP).

Conclusions: Isoagglutinin depletions within the first apheresis session were similar across cTP, fTP, and DFPP: this was numerically lower for DFPP.

Keywords: ABO incompatible; centrifugation plasmapheresis; double-filtration plasmapheresis; filtration plasmapheresis; kidney transplantation.

PubMed Disclaimer

References

REFERENCES

    1. Nakanishi T, Suzuki N, Kuragano T, Nagasawa Y, Hasuike Y. Current topics in therapeutic plasmapheresis. Clin Exp Nephrol. 2014;18(1):41-49. https://doi.org/10.1007/s10157-013-0838-0.
    1. Alamartine E, Maillard N. Therapeutic plasma exchange in nephrology. Where it applies? Transfus Apher Sci. 2019;58(3):262-265. https://doi.org/10.1016/j.transci.2019.04.010.
    1. Hirano R, Namazuda K, Suemitsu J, Harashima T, Hirata N. Plasma separation using a membrane. Transfus Apher Sci. 2017;56(5):649-653. https://doi.org/10.1016/j.transci.2017.08.008.
    1. Maggioni S, Allal A, Kamar N, Hermelin M, Faubel E, Rostaing L. Immunoadsorption and hemodialysis as a tandem procedure: a single-center experience of more than 60. Int J Artif Organs. 2015;38(6):304-310. https://doi.org/10.5301/ijao.5000420.
    1. Takahashi K, Saito K. ABO-incompatible kidney transplantation. Transplant Rev (Orlando). 2013;27(1):1-8. https://doi.org/10.1016/j.trre.2012.07.003.

LinkOut - more resources