Plasmapheresis Therapy in Renal Transplant Patients: Five-Year Experience

• Published in: Transplantation proceedings Vol. 43; no. 3; pp. 853 - 857
• Main Authors: Gungor, O., Sen, S., Kircelli, F., Yilmaz, M., Sarsik, B., Ozkahya, M., Hoscoskun, C., Ok, E., Toz, H.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01.04.2011; Elsevier
• Subjects: Adult; Biological and medical sciences; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Rejection - prevention & control; Humans; Kidney Transplantation; Male; Medical sciences; Middle Aged; Plasmapheresis - adverse effects; Plasmapheresis - methods; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Thrombotic Microangiopathies - etiology; Tissue, organ and graft immunology; Human; Medicine; Experience; Treatment; Urinary system; Surgery; Graft; Patient; Transplantation; Homotransplantation; Kidney; Plasmapheresis
• ISSN: 0041-1345; 1873-2623; 1873-2623
• DOI: 10.1016/j.transproceed.2011.03.025

Plasma exchange (PE) and double-filtration plasmapheresis (DFPP) have been used successfully in renal transplant patients as well as those with various other diseases over the last decade. In this retrospective study, we sought to explore the outcomes of plasmapheresis in renal transplant patients. We investigated 58 patients who received PE or DFPP therapy between 2005 and 2010. PE was performed using a Fresenius AS.TEC 204 device and DFPP, by an INFOMED HF 440 device. Indications for therapy, biopsy findings, number of PE/DFPP sessions, laboratory data, medications, complications as well as graft and patient survivals were recorded. Overall mean age of subjects was 34.1 ± 8.8 years and 55% were female. Sixteen patients underwent 95 DFPP sessions and 42 underwent 215 PE sessions. Indications for therapy were acute humoral rejection ( n = 39), recurrent focal segmental glomerulosclerosis (FSGS; n = 8), thrombotic microangiopathy ( n = 6), and chronic humoral rejection ( n = 5). Responses to therapy were 24/39 for acute humoral rejection, 1/5 for chronic rejection, 4/8 for FSGS, and 3/6 for thrombotic microangiography. No complication was observed in any patient. PE/DFPP is a safe and succesful method for treatment of acute humaral rejection as less so for recurrent FSGS and thrombotic microangiopathy. The outcomes among subjects with chronic humoral rejection were not satisfactory.