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Related Experiment Videos

Acute vascular rejection treated by plasma exchange.

W Fassbinder1, D Jonas, W Ernst

  • 1Dept. Nephrology, University Hospital Frankfurt/Main, Federal Republic of Germany.

Life Support Systems : the Journal of the European Society for Artificial Organs
|January 1, 1983
PubMed
Summary

Plasmafiltration (PF) effectively treats steroid-resistant acute vascular rejection (AVR) in kidney grafts. This safe procedure improves renal function and prevents irreversible graft loss, with most patients showing no signs of rejection post-treatment.

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Area of Science:

  • Nephrology
  • Transplantation Immunology

Background:

  • Acute vascular rejection (AVR) often leads to irreversible kidney graft loss.
  • Standard immunosuppression is frequently ineffective against steroid-resistant AVR.

Purpose of the Study:

  • To evaluate the efficacy of plasmafiltration (PF) combined with immunoglobulin (IVIg) substitution for treating steroid-resistant AVR.
  • To assess the long-term graft survival and function in patients receiving PF treatment.

Main Methods:

  • 27 episodes of steroid-resistant AVR in 22 patients were treated with PF (6 x 5 L plasma filtered per episode).
  • Plasma was replaced with 3.5% Albumin-Ringer-lactate, followed by 20g of intravenous immunoglobulin (IVIg) after each PF session.
  • Renal function and signs of rejection were monitored post-treatment.

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Main Results:

  • All patients experienced improved renal function immediately following PF treatment.
  • One graft was lost to chronic rejection; 2 patients did not respond to PF.
  • 19 grafts were functioning at 6 months and 8 at 12 months post-treatment, with no signs of rejection.

Conclusions:

  • Plasmafiltration with immunoglobulin repletion is a safe and effective method for reversing acute vascular rejection in kidney transplants.
  • This treatment strategy significantly improves graft survival rates in patients with steroid-resistant AVR.
  • PF offers a viable alternative for managing difficult-to-treat acute vascular rejection episodes.