Protein A immunoadsorption therapy in the highly sensitized kidney transplant candidates

• Published in: Chinese medical journal Vol. 124; no. 5; pp. 780 - 782
• Main Authors: Jin, Qing, Liu, Hang, Song, Lin-Yan, Huang, Jing, Chang, Yan, Zhang, Mei, Shi, Yi-Min
• Format: Journal Article
• Language: English
• Published: China Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China 01.03.2011
• Subjects: Adult; Female; Humans; Immunosorbents - therapeutic use; Kidney Transplantation - immunology; Kidney Transplantation - methods; Male; Middle Aged; Staphylococcal Protein A - therapeutic use; 人类白细胞抗原; 候选人; 免疫吸附; 有害生物风险分析; 监督程序; 肾移植; 蛋白A; 血清免疫球蛋白; protein A immunoadsorption; transplant candidates; sensitization
• ISSN: 0366-6999; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.2011.05.027

Background Sensitization in transplant candidates increases risk of irreversible immunologic injury of graft in the early period postoperatively. Elimination of anti-human leukocyte antigen （HLA） antibodies using protein A immunoadsorption （IA） might benefit these patients.Methods Protein A IA was used in 21 patients with high panel reactive antibody （PRA）. The patients had IA 1-6 times （median 5 times） with the interval period was 2-5 days （median 2.5 days）.Results Total 67 IA procedures were carried out smoothly in all patients. IA treatment reduced PRA I （pre （31.4±3.8）% vs. post （24.4±3.4）%, P 〈0.01） and II （pre （37.1±4.3）% vs. post （34.1±3.9）%, P 〈0.01）. However, PRA did not change in some patients after the treatment. The serum immunoglobulin （IgG, IgM and IgA） and complement C3, C4 level were decreased significantly. Hemoglobin and albumin levels were slightly decreased associated with IA procedures. Flu-like symptoms were observed in a few of cases during the procedure but generally mild and transient.Conclusion Protein A IA is capable to efficiently remove serum immunoglobulin and complement, reduce HLA class I and class II PRA in high sensitized transplant candidates, which is likely to benefit the kidney transplantation in these patients.