Antibody elimination by apheresis in living donor liver transplant recipients.
In the present study, we investigated retrospectively the indications and the efficacy of the elimination of preexisting antiallogeneic antibodies in liver transplant recipients. Three patients who were ABO blood type incompatible were subjected to plasmapheresis and double filtration plasmapheresis before the living donor liver transplantation (LDLTx), and the titers decreased to less than 8. After transplantation, plasmapheresis was also performed in 3 cases, and continuous hemodiafiltration in 1 case, and in 2 out of these 3 patients acute rejection was recognized. Two patients who were crossmatch positive were subjected to plasmapheresis before transplantation, and the T warm titers were reduced to less than Score 2. These 2 patients had no acute rejections after transplantation. We conclude that in liver transplant patients apheresis is effective to prevent acute rejection induced by preexisting anti-A and/or anti-B antibodies and anti-donor specific antibodies before transplantation, but it is not effective in a patient with accelerated humoral rejection occurring after transplantation.
Kawagishi
N
N
Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Sendai, Japan.
Ohkohchi
N
N
Fujimori
K
K
Orii
T
T
Koyamada
N
N
Kikuchi
H
H
Sekiguchi
S
S
Tsukamoto
S
S
Sato
T
T
Satomi
S
S
D000017:ABO Blood-Group System / Q000097:blood / Q000276:immunology; D000906:Antibodies / Q000097:blood*; D001781:Blood Component Removal; D006084:Graft Rejection / Q000517:prevention & control; D017583:Hemodiafiltration; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D010956:Plasmapheresis; D012189:Retrospective Studies
D000017:ABO Blood-Group System; D000906:Antibodies