Isoagglutinin removal by plasma centrifugation or filtration (single or double): A prospective study in a single center
| Autor: | Thomas Jouve, Bénédicte Janbon, Johan Noble, Claudine Giroux-Lathuile, Paolo Malvezzi, Eloi Chevallier, Farida Imerzoukene, Lionel Rostaing, Hamza Naciri Bennani, Mathilde Bugnazet, Florian Terrec, Lionel Motte |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Serial dilution medicine.medical_treatment Urology Centrifugation 030204 cardiovascular system & hematology Single Center ABO Blood-Group System 03 medical and health sciences 0302 clinical medicine medicine Humans Prospective Studies Prospective cohort study Kidney transplantation Aged business.industry Therapeutic plasmapheresis Plasmapheresis Hematology General Medicine Middle Aged medicine.disease Kidney Transplantation Titer Hemagglutinins Blood Group Incompatibility Immunoglobulin G Female business Filtration 030215 immunology |
| Zdroj: | Journal of Clinical Apheresis. 36:149-160 |
| ISSN: | 1098-1101 0733-2459 |
| DOI: | 10.1002/jca.21857 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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