*Purpose: Therapeutic plasma exchange (TPE) is either performed using a highly permeable filter with standard multifunctional renal replacement equipment (mTPE) or a centrifugation device (cTPE). Although both techniques are well established in clinical practice, performance of these two modes of TPE was never compared in antibody-mediated rejection (AMR).

*Methods: A cohort retrospective study with 27 patients with AMR were analyzed between 2016 to 2020. 14 patients were treated with cTPE and 13 with mTPE. Each patient received 5 sessions of TPE, plus IV immunoglobulin and rituximab. The primary endpoints were a comparison between cTPE and mTPE efficacy in different response markers of AMR. Statistics: Data are presented as median and SD. Comparisons between both techniques and between pre-and post-TPE laboratory marker levels were performed using a paired t test. Differences were considered to be statistically significant if p values were <0.05.

*Results: Mean age was 33±9 years, 22 (81%) were living donor recipients. Sensitizing events occurred in 19 (70%). The mean AMR time appearance was 25 months (3 min- 108 max). C4d positivity in 11 (40%) patients. Both treatments were comparable at the end of 3-months post treatment in terms of decrease in creatinine levels (post cTPE 0.4 ±0.7 and post mTPE 0.2 ±0.2 mg/dL, p=0.21), increment in eGFR (post cTPE 6.4 ±16 and post mTPE 6.1 ±10 ml/min, p=0.99), panel-reactive antibody class I reduction percent (post cTPE 2 ±4 and post mTPE 2 ±4 %, p=0.91), and panel-reactive antibody class II (post cTPE 4 ±6 and post mTPE 4 ±4 %, p=0.99), DSA MFI class I reduction percent (post cTPE 41.1% and post mTPE 29.1%, p=0.55), and DSA MFI class II (post cTPE 34.8% and post mTPE 27.3%, p=0.51). (Figure 1).

*Conclusions: The improvement between cTPE and mTPE in markers of AMR response were not different between groups.

« Back to 2021 American Transplant Congress