title: Management of anti-allogeneic antibody elimination by apheresis in living donor liver transplantation.
abstract: In this study, we report on the indications and efficacy of the elimination of antiallogeneic antibodies in living donor liver transplant recipients. Seven patients incompatible with the ABO-blood type were subjected to apheresis before transplantation. The procedure resulted in titers being decreased to less than a score of 8. After transplantation, apheresis was also performed in 6 cases and continuous hemodiafiltration in 1 case. In addition, three out of 11 ABO-blood type incompatible recipients were administered anti-CD20 antibody (rituximab). Two crossmatch positive patients were subjected to apheresis before transplantation, and in these cases the titers were reduced to less than a score of 2. Moreover, these two patients had no acute rejections after transplantation. We concluded that apheresis is effective for preventing acute rejection induced by pre-existing anti-A and/or anti-B antibodies, as well as antidonor specific antibodies, but is not effective in some patients who had accelerated humoral rejection.
authors.affiliation: Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Sendai, Japan. kawan@mail.tains.tohoku.ac.jp
authors.forename: Naoki
authors.initials: N
authors.lastname: Kawagishi
authors.forename: Ikuo
authors.initials: I
authors.lastname: Takeda
authors.forename: Shigehito
authors.initials: S
authors.lastname: Miyagi
authors.forename: Kazushige
authors.initials: K
authors.lastname: Satoh
authors.forename: Yorihiro
authors.initials: Y
authors.lastname: Akamatsu
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sekiguchi
authors.forename: Keisei
authors.initials: K
authors.lastname: Fujimori
authors.forename: Toshinobu
authors.initials: T
authors.lastname: Sato
authors.forename: Susumu
authors.initials: S
authors.lastname: Satomi
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D001787:Blood Group Incompatibility / Q000628:therapy*; D001788:Blood Grouping and Crossmatching; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007518:Isoantibodies / Q000302:isolation & purification*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis / Q000379:methods*
chemical_list: D000017:ABO Blood-Group System; D007518:Isoantibodies