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Related Experiment Video

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Reusable Single Cell for Iterative Epigenomic Analyses
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Immunoadsorption Column Reuse.

Vaibhav Tiwari1, Anurag Gupta1, Smita Divyaveer2

  • 1Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India.

Indian Journal of Nephrology
|May 17, 2021
PubMed
Summary
This summary is machine-generated.

Reusing immunoadsorption (IA) columns for ABO-incompatible kidney transplants (ABOiRT) effectively reduces antibody titers. This cost-effective method is safe and successful for multiple uses in ABOiRT.

Keywords:
ABO-incompatible Transplantimmunoadsorption columnkidney transplantplasma exchangereuse of IA columnsselective IA columns

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Area of Science:

  • Nephrology
  • Transplant Surgery
  • Immunology

Background:

  • Selective immunoadsorption (IA) is crucial for removing preformed Anti-ABO antibodies in ABO-incompatible renal transplants (ABOiRT).
  • High costs and limited efficacy of single-use IA columns hinder widespread adoption in ABOiRT.
  • This study investigates the safety and efficacy of reusing IA columns for ABOiRT.

Purpose of the Study:

  • To evaluate the effectiveness of reusing immunoadsorption (IA) columns in reducing Anti-ABO antibody titers for ABO-incompatible renal transplants (ABOiRT).
  • To assess the safety and identify any adverse reactions associated with the reuse of IA columns in ABOiRT patients.
  • To determine the feasibility of IA column reuse as a cost-effective strategy in ABOiRT.

Main Methods:

  • Retrospective analysis of 16 patients undergoing ABOiRT with IA column reuse (January 2016 - July 2018).
  • IA columns were sterilized with ethylene oxide and reused up to two times, targeting pre-operative IgG titers of 1:4.
  • Key outcomes included IgG titer reduction, plasma volume processed, and postoperative rebound, with a 1-year follow-up.

Main Results:

  • IA column reuse was performed 23 times, with 9 columns undergoing a second reuse, treating an average of 22 L of plasma.
  • Significant log titer reductions were observed: 4 logs after first use, 3 logs after first reuse, and 1.5 logs after second reuse.
  • 75% of patients achieved target IgG titers (≤1:4) solely through column reuse, with no serious adverse events reported.

Conclusions:

  • Reuse of IA columns up to two times is effective in significantly reducing antibody titers for ABOiRT.
  • IA column reuse demonstrates a favorable safety profile, with no significant side effects observed.
  • Column reuse presents a viable and potentially cost-effective approach for managing antibody levels in ABOiRT.