title: [Immunoadsorption in highly sensitized renal transplant recipients].
abstract: OBJECTIVE
  to investigate the efficacy and safety of protein A immunoadsorption (IA) therapy in the prevention of highly sensitized renal transplant recipients with acute rejection.
  
  
  METHODS
  a retrospective analysis of preoperative clinical data was carried out in 12 renal transplant patients in our hospital from March 2008 to October 2009 with a high level of panel reactive antibody (PRA). Serum PRA and IgG, IgM, IgA were detected at pre and post-treatment. The acute rejection responses and adverse effects were observed.
  
  
  RESULTS
  at post-treatment, PRA of both Class I and II antibody [14% (4%, 27%) vs 86% (73%, 98%), 6% (0, 23%) vs 68% (34%, 88%), P < 0.01] and serum total IgG levels significantly decreased [(550 ± 341) g/L vs (1301 ± 393) g/L, P < 0.01]. IgA and IgM were also lower than those at pre-treatment [(144 ± 78) g/L vs (185 ± 93) g/L, (103 ± 48) g/L vs (131 ± 66) g/L, P < 0.01]. Five cases had acute rejection reversible by anti-thymocyte globulin (ATG) or combined IA (n = 2). Within 6 months, 1 cases developed Aspergillus pneumonia, 2 cases of Pneumocystis carinii pneumonia were cured.
  
  
  CONCLUSIONS
  IA therapy can reduce antibody levels in highly sensitized renal transplant recipients. When supplemented with induction therapy, it can effectively prevent and reduce rejection after renal transplantation.
authors.affiliation: Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
authors.forename: Wei
authors.initials: W
authors.lastname: WANG
authors.forename: Hang
authors.initials: H
authors.lastname: LIU
authors.forename: Hang
authors.initials: H
authors.lastname: YIN
authors.forename: Xiao-bei
authors.initials: XB
authors.lastname: LI
authors.forename: Xiao-yong
authors.initials: XY
authors.lastname: YANG
authors.forename: Liang
authors.initials: L
authors.lastname: REN
authors.forename: Xiao-peng
authors.initials: XP
authors.lastname: HU
authors.forename: Yong
authors.initials: Y
authors.lastname: WANG
authors.forename: Xiao-dong
authors.initials: XD
authors.lastname: ZHANG
mesh_terms: D000328:Adult; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007163:Immunosorbent Techniques; D016030:Kidney Transplantation / Q000276:immunology / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome