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Orthotopic Rat Kidney Transplantation: A Novel and Simplified Surgical Approach
Published on: May 7, 2019
ABO-incompatible kidney transplantation using regenerative selective immunoglobulin adsorption
Sven Teschner1, Dirk Stippel, Roland Grunenberg
1Transplant Center Cologne, University Hospital Cologne, Cologne, Germany. steschner@me.com
Journal of Clinical Apheresis
|January 25, 2012
Summary
A new regenerative immunoglobulin immunoadsorption effectively lowers antibody titers for ABO-incompatible kidney transplants. This method offers a safe and efficient alternative to traditional carbohydrate adsorbers, achieving comparable outcomes.
Area of Science:
- Nephrology
- Immunology
- Transplantation Science
Background:
- ABO-incompatible (ABOi) kidney transplantation requires preconditioning to remove donor-specific isoagglutinine antibodies.
- Current protocols utilize single-use carbohydrate isoagglutinine adsorbers.
- Regenerative immunoglobulin immunoadsorption has not been previously reported for ABOi transplantation.
Purpose of the Study:
- To evaluate the safety and efficacy of a regenerative polyclonal sheep anti-immunoglobulin adsorber for ABOi kidney transplantation.
- To compare outcomes with conventional isoagglutinine carbohydrate epitope adsorbers.
Main Methods:
- Retrospective comparison of eight patients treated with carbohydrate adsorbers and seven with immunoglobulin adsorbers.
- Patients qualified for transplantation with an IgG-isoagglutinine titer ≤ 1:4.
- Assessed treatment safety, efficiency, desensitization duration, and postoperative outcomes.
Main Results:
- Immunoglobulin adsorber lowered median initial IgG titers from 1:64 to ≤ 1:4 with a mean of 6.2 adsorptions.
- Desensitization duration and number of adsorptions were comparable to carbohydrate adsorbers.
- No postoperative rejection or adverse events were observed; graft function was similar.
Conclusions:
- Selective regenerative immunoglobulin immunoadsorption is a safe and effective option for ABOi kidney transplantation.
- This approach provides a viable alternative to existing desensitization protocols.
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