Anti-HLA antibodies depletion on protein A-sepharose columns in hyperimmunized patients awaiting renal transplantation.
To reduce anti-HLA immunization, 15 patients waiting for a renal graft received the following treatment: 5 to 7 immunoadsorption sessions on protein A-Sepharose columns, immunosuppressive drugs (corticosteroids 1 mg/kg (bw/day+cyclophosphamide 2 mg/kg bw/day) and iv polyclonal immunoglobulins. Before this treatment, panel-reactive antibodies ranged from 65 to 100% and antibody titers varied from 1/8 to 1/128. In all patients, antibody, titers were decreased. However, antibody resynthesis was incompletely blocked by this protocol. Eight out of 12 grafted patients had a functional kidney transplant 3 months to 3 years post-grafting. There early kidney failures occurred in the subgroup of 5 patients who had had historical positive cross matches prior to treatment. This treatment did not seem to increase the frequency of infectious complications before or after grafting.
Kriaa
F
F
Service de Néphrologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre.
Rousseau
P
P
Hiesse
C
C
Farahmand
H
H
Brocard
J F
JF
Rieu
P
P
Lantz
O
O
Farquet
C
C
Bismuth
A
A
Benoit
G
G
D000328:Adult; D000906:Antibodies; D005260:Female; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G; D007163:Immunosorbent Techniques; D016030:Kidney Transplantation; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects; D012685:Sepharose; D013205:Staphylococcal Protein A
D000906:Antibodies; D006680:HLA Antigens; D007074:Immunoglobulin G; D013205:Staphylococcal Protein A; D012685:Sepharose