title: The effect of different apheresis modalities on coagulation factor XIII level during antibody removal in ABO-blood type incompatible living related renal transplantation.
abstract: Apheresis therapy is used to remove pathogenic antibodies within the recipient blood during ABO-incompatible living related renal transplantation (LRRT). Factor XIII (FXIII) is a coagulating factor. Its deficiency reportedly engenders perioperative bleeding. This study compared apheresis modalities from the perspective of the FXIII level. Cases 1-3 were treated only with double-filtration plasmapheresis (DFPP) without (case 1) or with (cases 2 and 3) fresh frozen plasma (FFP) supplementation. Cases 4 and 5 were treated with simple plasma exchange (PEx) with FFP supplementation for the last session. Cases 1-3 showed a marked (case 1, 8.6%) or moderate (case 2, 26.2%; case 3, 28.4%) decrease in FXIII on the day before the procedure after the last apheresis session, although cases 4 (81.9%) and 5 (66.2%) did not. Case 1 experienced perioperative bleeding. The last session is usually performed the day before the surgical procedure. Therefore, FXIII elimination by DFPP might cause bleeding complications because of its slow recovery. The fact warrants that the last apheresis modality during the course might be PEx from the viewpoint of FXIII depletion.
authors.affiliation: Department of Hemodialysis and Apheresis, The University of Tokyo Hospital, Japan. Electronic address: hanafusa-tky@umin.ac.jp.
authors.forename: Norio
authors.initials: N
authors.lastname: Hanafusa
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Hamasaki
authors.forename: Hiroo
authors.initials: H
authors.lastname: Kawarasaki
authors.forename: Ryo
authors.initials: R
authors.lastname: Kido
authors.forename: Yugo
authors.initials: Y
authors.lastname: Shibagaki
authors.forename: Akira
authors.initials: A
authors.lastname: Ishikawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Enomoto
authors.forename: Toshiro
authors.initials: T
authors.lastname: Fujita
authors.forename: Eisei
authors.initials: E
authors.lastname: Noiri
authors.forename: Masaomi
authors.initials: M
authors.lastname: Nangaku
mesh_terms: D000017:ABO Blood-Group System / Q000097:blood*; D000328:Adult; D064591:Allografts; D001781:Blood Component Removal / Q000009:adverse effects*; D005169:Factor VIII / Q000378:metabolism*; D005260:Female; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000097:blood / Q000517:prevention & control; D012189:Retrospective Studies
chemical_list: D000017:ABO Blood-Group System; D007518:Isoantibodies; C078147:F8 protein, human; D005169:Factor VIII
keywords: Antibody removal; Coagulation factor XIII; Double filtration plasmapheresis; Living Related; Renal Transplantation; Simple plasma exchange