Is Pre-transplant Plasmapheresis For Patients With Insignificant Abo Blood Type Antibody In Abo Blood Type Incompatible Kidney Transplant Necessary? – A Japanese Single Center Study.
Urology and Kidney Transplant Surgery, Sapporo City General Hospital, Sapporo, Hokkaido, Japan
Meeting: 2019 American Transplant Congress
Abstract number: D94
Keywords: Antibodies, Kidney transplantation, Plasmapheresis, Rejection
Session Information
Session Name: Poster Session D: Kidney Acute Antibody Mediated Rejection
Session Type: Poster Session
Date: Tuesday, June 4, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: ABO incompatible kidney donor (ABOiKT) is still precious to fill up the extremely organ donor shortages in our country. Though plasmaphresis (PP) as desensitization is considered helpful for overcoming the reactions between graft antigens and recipient antibodies that cause graft rejection, the usefulness remain incompletely demonstrated. As the accumulation of cases, the procedure of desensitization has been arranged such as PP sparing policy according to the pre-operative Ab strength. However, the usefulness of PP for removing Ab has thoroughly investigated. We studied the early outcome of ABOiKT with focusing PP.
*Methods: Twenty-six patients underwent ABOiKT in our hospital from 2017 to 2018 were analyzed in this study. All recipients received tacrolimus, mycophenolate mofetil, everolimus, basiliximab and rituximab. To assess the usefulness of PP, the patients were divided into two groups: PP group (desensitization with pre-transplant PP, n=14), and non-PP (PP sparing desensitization, n=12) and studied the early outcome of ABOiKT.
*Results: The recipient and donor ages were 58 (range 18-70) and 61 (range 43-76), respectively. The recipient and the donor genders were 18 and 7 males, respectively. No recipients had preformed donor specific HLA antibody. The patient background were similar between two groups, for instance gender, preemptive kidney transplantation or not, age at the surgery and body mass index. IgG titer was slightly high in PP group compared to non-PP group; 32x and 16x at the initial visit, and 12x and 4x at the point of operation, respectively. We experienced acute antibody mediated rejection (biopsy proven) in two recipients only in non-PP group after transplantation, which was statistical marginally significant (p=0.069).
*Conclusions: The interest in overcoming the ABO incompatibility has been increasing with demand for kidney donations. From our result, we should recognize the importance of PP during pre-transplant desensitization even, low Ab population. More big data analytics and discussions are needed to clear this concern.
To cite this abstract in AMA style:
Miyazaki M, Mitsuke A, Higuchi H, Fukuzawa N, Tanaka H, Hirano T, Seki T, Harada H. Is Pre-transplant Plasmapheresis For Patients With Insignificant Abo Blood Type Antibody In Abo Blood Type Incompatible Kidney Transplant Necessary? – A Japanese Single Center Study. [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/is-pre-transplant-plasmapheresis-for-patients-with-insignificant-abo-blood-type-antibody-in-abo-blood-type-incompatible-kidney-transplant-necessary-a-japanese-single-center-study/. Accessed May 13, 2025.« Back to 2019 American Transplant Congress