Plasma exchange in renal allograft rejection.
Circulating anti-HLA antibodies against mismatched donor antigen have been found in 7 patients during acute rejection episodes, where renal biopsy showed severe vascular lesions. 4 patients were submitted to combined therapy with plasmapheresis and cyclophosphamide, while the other 3 were treated by cyclophosphamide alone. In the 4 patients treated plasmapheresis induced a rapid disappearance of circulating cytotoxic antibodies, which remained negative in 3 cases where cyclophosphamide was continued after plasmapheresis. No change in antibody occurred in the three cases treated by cyclophosphamide alone. Renal function showed an improvement in 3 of the 4 patients treated by plasma exchange; all patients on drug therapy alone showed a rapid and progressive impairment of renal function and returned to RDT within 2 months.
D000293:Adolescent; D000328:Adult; D000906:Antibodies / Q000032:analysis; D002648:Child; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D006084:Graft Rejection / Q000187:drug effects; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007668:Kidney / Q000502:physiology; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D010951:Plasma Exchange
D000906:Antibodies; D006680:HLA Antigens; D003520:Cyclophosphamide; D008775:Methylprednisolone