Protein A-Based Immunoadsorption Is More  Efficient Than Conventional Plasma Exchange  to Remove Circulating Anti-HLA Antibodies.
We retrospectively evaluated the ability of protein-A immunoadsorption (IA) as compared to that of conventional plasma exchanges (PE) in reducing the mean fluorescence intensity (MFI) of anti-HLA antibodies assessed by the single antigen assay in sensitized renal transplant recipients. Change in MFI of 441 anti-HLA antibodies was measured after 1 single session of IA or after 3 consecutive daily PE sessions. While both strategies were able to significantly lower the amount of anti-HLA antibodies, the relative reduction in MFI was higher after IA as compared to PE (-69 vs. -58%, respectively, p = 0.003). This better efficacy of IA was observed despite a lower total volume of treated plasma (105 ± 6 vs. 160 ± 16 ml/kg after IA and after PE, respectively). Our data suggest a higher efficiency of IA over conventional PE sessions to remove anti-HLA antibodies and call for a larger evaluation of IA to confirm its potential added value in desensitization protocols.
Nicolas
N
Maillard
Lena
L
Absi
Guillaume
G
Claisse
Ingrid
I
Masson
Eric
E
Alamartine
Christophe
C
Mariat
D000906:Antibodies / Q000097:blood / Q000302:isolation & purification*; D006680:HLA Antigens / Q000097:blood / Q000276:immunology; D006801:Humans; D007163:Immunosorbent Techniques; D016030:Kidney Transplantation; D010951:Plasma Exchange / Q000295:instrumentation / Q000379:methods*; D051436:Renal Insufficiency, Chronic / Q000276:immunology / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D013205:Staphylococcal Protein A / Q000737:chemistry*
D000906:Antibodies; D006680:HLA Antigens; D013205:Staphylococcal Protein A