Protein A immunoadsorption therapy in the highly sensitized kidney transplant candidates.
- Author:
Qing JIN
1
;
Hang LIU
;
Lin-Yan SONG
;
Jing HUANG
;
Yan CHANG
;
Mei ZHANG
;
Yi-Min SHI
Author Information
- Publication Type:Clinical Trial
- MeSH: Adult; Female; Humans; Immunosorbents; therapeutic use; Kidney Transplantation; immunology; methods; Male; Middle Aged; Staphylococcal Protein A; therapeutic use
- From: Chinese Medical Journal 2011;124(5):780-782
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDSensitization 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.
METHODSProtein 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).
RESULTSTotal 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.
CONCLUSIONProtein 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.