Plasmapheresis in a Renal Transplant Patient with Positive Crossmatch only Detected by Flow Cytometry.
- Author:
You Kyoung KIM
1
;
Jang Soo SUH
Author Information
1. Department of Laboratory Medicine, School of Medicine, Kyungpook National University, Daegu, Korea. suhjs@knu.ac.kr
- Publication Type:Case Report
- Keywords:
positive HLA crossmatch;
plasmapheresis;
flow cytometric crossmatch
- MeSH:
Adult;
Antibodies;
Female;
Flow Cytometry*;
Graft Survival;
Humans;
Immunoglobulins;
Kidney Failure, Chronic;
Plasmapheresis*;
Tacrolimus;
Transplants
- From:Korean Journal of Blood Transfusion
2004;15(2):236-240
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Complement-dependent cytotoxicity (CDC) has been established as a crossmatch (XM) technique that can effectively prevent hyperacute transplantation rejetion by detecting preformed complement-fixing antibodies. The anti-human globulin crossmatch (AHGXM) has been performed in an effort to improve sensitivity for detecting anti-donor antibodies. Flow cytometry crossmatch (FCXM) was introduced as a more sensitive technique than the traditional CDCXM or AHGXM. A positive pre-transplant FCXM in recipients with a negative CDCXM or AHGXM has been found to be associated with a poor graft survival in several studies. Many clinical studies have focused on suppressing or eliminating anti-donor antibodies through the use of immunosuppresive drugs, immunoadsorption, intravenous immunoglobulin, or plasmapheresis. We performed plasmapheresis with intravenous immunoglobulin and FK 506 for a 38-year old female patient with chronic renal failure to remove anti-donor antibody which was only detected by FCXM. After transplant, no evidence of hyperacute or acute rejection was found. After 6 month, the recipient was surviving with well-functioning graft.
