Plasmapheresis followed by intravenous immunoglobulin in presensitized patients awaiting thoracic organ transplantation.
Four highly sensitized patients awaiting thoracic organ transplantation were treated immediately preceding transplantation with 1 plasmapheresis and infusion of high dose intravenous immunoglobulin (IVIG). All 4 underwent successful surgery and have had minor to no rejection episodes over a range from 5 1/2 to 12 months. All panel reactive antibodies (PRA) were dithiotheitol (DTT) resistant, and 1 patient had IgG specific alloantibodies to a donor alloantigen. All 4 patients had positive donor cross matches prior to transplantation, and 3 of the 4 patients remained PRA negative for up to 9 months after allografting. Possible mechanisms of this therapy include inhibition of proliferating alloreactive B cells or suppression by antiidiotypic antibodies. Further study is warranted.
Robinson
J A
JA
Department of Rheumatology, Loyola University of Chicago at the Medical Center, Maywood, Illinois 60153, USA.
Radvany
R M
RM
Mullen
M G
MG
Garrity
E R
ER
D005260:Female; D016027:Heart Transplantation; D006650:Histocompatibility Testing; D006801:Humans; D016756:Immunoglobulins, Intravenous; D016040:Lung Transplantation; D007959:Lymphocyte Culture Test, Mixed; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis
D016756:Immunoglobulins, Intravenous