title: Effect of Apheresis for ABO and HLA Desensitization on Anti-Measles Antibody Titers in Renal Transplantation.
abstract: Desensitization strategies for ABO-incompatible renal transplants with plasma exchange (PE) or specific immunoadsorption (IA) decrease immunoglobulin levels. After recent measles outbreak and decreasing vaccination rates, we studied the impact of apheresis on anti-measles antibodies. Anti-measles antibodies were measured before desensitization, before transplantation and during followup in 12 patients with ABO incompatibility (2x PE only, 8x IA only, and 2x IA and PE) and 3 patients with donor-specific HLA antibodies (all PE). Patients received rituximab, IVIG, and standard immunosuppressive therapy. All patients had detectable anti-measles antibodies before desensitization (mean 3238 mU/l, range 560-8100). After 3-6 PE sessions, titers decreased significantly to 1710 mU/l (P < 0.05), in one patient to nondetectable values, while IA only maintained protective titers. After a median followup of 64 days, anti-measles antibodies returned to baseline in all patients. Immunity against measles was temporarily reduced by apheresis but remained detectable in most patients at time of transplantation. Desensitization maintains long-term protective immunity against measles.
authors.affiliation: Nephrology Division, Department I of Internal Medicine, University Hospital Munich-Campus Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, D-81377 Munich, Germany.
authors.forename: Ulf
authors.initials: U
authors.lastname: Schönermarck
authors.forename: Teresa
authors.initials: T
authors.lastname: Kauke
authors.forename: Gundula
authors.initials: G
authors.lastname: Jäger
authors.forename: Antje
authors.initials: A
authors.lastname: Habicht
authors.forename: Thorsten
authors.initials: T
authors.lastname: Wendler
authors.forename: Joachim
authors.initials: J
authors.lastname: Andrassy
authors.forename: Markus
authors.initials: M
authors.lastname: Guba
authors.forename: Manfred
authors.initials: M
authors.lastname: Stangl
authors.forename: Michael
authors.initials: M
authors.lastname: Fischereder