Perioperative application of immunoadsorption in highly sensitized kidney transplant recipients: single-center experience
10.3760/cma.j.cn421203-20230928-00107
- VernacularTitle:免疫吸附在高致敏肾移植受者围手术期应用的单中心经验总结
- Author:
Haojie HUANG
1
;
Jie DING
;
Yuting HU
;
Dan SONG
;
Ming ZHU
;
Feng WANG
;
Heng ZHENG
;
Chenjie HUANG
;
Qingling ZOU
;
Zhangfei SHOU
Author Information
1. 浙江树人学院树兰国际医学院附属树兰杭州医院肾脏病科，全省人工器官与计算医学重点实验室，杭州 310022
- Keywords:
Kidney transplantation;
Immunoadsorption;
Anti-human leukocyte antigen antibody;
Antibody-mediated rejection;
Highly sensitized recipient
- From:
Chinese Journal of Organ Transplantation
2024;45(10):702-709
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical efficacy of immunoadsorption in highly sensitized kidney transplant (KT) candidates.Methods:From September 2019 to April 2023, the relevant clinical data were retrospectively reviewed for 26 highly sensitized KT recipients. Protein A immunoadsorption desensitization therapy was offered after KT. The effect of immunosorbent on reducing anti-human leukocyte antigen (HLA) antibodies was summarized. And operative success rate and postoperative complication incidence were calculated.Results:The mean number of treatment session was (10.76±5.53). The highest level of HLA-Ⅰ antibody mean fluorescence intensity (MFI) dropped from (17 921±4 442) to (7 333±6 434) with a decline of 59% and HLA-Ⅱ antibody MFI decreased from (21 135±5 245) to (10 989±7 627) with a decline of 48%. The differences were statistically significant (both P<0.001). All kidneys were harvested from cadavers. The complications were acute antibody mediated rejection (7 cases), perioperative pulmonary infection (3 cases) and myelosuppression (2 cases). The average follow-up period was (30.8±12.6) month. The graft survival rate was 88.5% (23/26) and the recipient survival rate 100% (26/26) . Conclusions:Immunoadsorption therapy can effectively reduce HLA antibody in highly sensitized KT candidates, thereby increasing the probability of successful KT. In terms of safety, immunosorbent therapy may boost the potential risks of infection and myelosuppression. It requires heightened attention.
