title: Plasmapheresis therapy in renal transplant patients: five-year experience.
abstract: BACKGROUND
  Plasma exchange (PE) and double-filtration plasmapheresis (DFPP) have been used successfully in renal transplant patients as well as those with various other diseases over the last decade. In this retrospective study, we sought to explore the outcomes of plasmapheresis in renal transplant patients.
  
  
  METHODS
  We investigated 58 patients who received PE or DFPP therapy between 2005 and 2010. PE was performed using a Fresenius AS.TEC 204 device and DFPP, by an INFOMED HF 440 device. Indications for therapy, biopsy findings, number of PE/DFPP sessions, laboratory data, medications, complications as well as graft and patient survivals were recorded.
  
  
  RESULTS
  Overall mean age of subjects was 34.1 ± 8.8 years and 55% were female. Sixteen patients underwent 95 DFPP sessions and 42 underwent 215 PE sessions. Indications for therapy were acute humoral rejection (n = 39), recurrent focal segmental glomerulosclerosis (FSGS; n = 8), thrombotic microangiopathy (n = 6), and chronic humoral rejection (n = 5). Responses to therapy were 24/39 for acute humoral rejection, 1/5 for chronic rejection, 4/8 for FSGS, and 3/6 for thrombotic microangiography. No complication was observed in any patient.
  
  
  CONCLUSIONS
  PE/DFPP is a safe and successful method for treatment of acute humaral rejection as less so for recurrent FSGS and thrombotic microangiopathy. The outcomes among subjects with chronic humoral rejection were not satisfactory.
authors.affiliation: Division on Nephrology, Ege University School of Medicine, Izmir, Turkey. ozkangungor@yahoo.com.tr
authors.forename: O
authors.initials: O
authors.lastname: Gungor
authors.forename: S
authors.initials: S
authors.lastname: Sen
authors.forename: F
authors.initials: F
authors.lastname: Kircelli
authors.forename: M
authors.initials: M
authors.lastname: Yilmaz
authors.forename: B
authors.initials: B
authors.lastname: Sarsik
authors.forename: M
authors.initials: M
authors.lastname: Ozkahya
authors.forename: C
authors.initials: C
authors.lastname: Hoscoskun
authors.forename: E
authors.initials: E
authors.lastname: Ok
authors.forename: H
authors.initials: H
authors.lastname: Toz
mesh_terms: D000328:Adult; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis / Q000009:adverse effects / Q000379:methods*; D057049:Thrombotic Microangiopathies / Q000209:etiology