title: [Renal transplantation in recipients with moderate presensitization].
abstract: OBJECTIVE
  to comparatively assess desensitization schemes with and without plasmapheresis in patients with low presensitization.
  
  
  METHODS
  The investigators studied the efficiency of the two desensitization schemes (cascade plasma filtration + intravenous immunoglobulin used in a dose of 100 mg/kg in 19 patients (a study group; panel reactive antibodies (PRA) 25.1±6.1%) versus 2 g/kg in 23 patients (a comparison group, PRA 18.9±4.4%). The crossmatch reaction was negative in both groups. The median follow-up period was 23.5 (quartiles 1 and 3: 10.25 and 26) months.
  
  
  RESULTS
  The study group was noted to have 6 episodes of acute rejection and 1 episode of infection; the comparison group had 13 and 3 episodes, respectively. The overall renal graft survival was 79 and 65% in the study and comparison groups, respectively; the 1-year graft survival was 94 and 62%. Graft function was significantly better in the study group: there was a lower daily proteinuria level (p<0.001) at 3 months after transplantation; a higher glomerular filtration rate (GFR) (p=0.001) and a lower daily proteinuria level (p=0.01) at 6 months; a lower serum creatinine comcentration (p=0.001) and lower daily proteinuria (p=0.001) and a higher GFR (p=0.001) at one year.
  
  
  CONCLUSIONS
  Even with the relatively low level of sensitization, there is an increase in the frequency of acute rejection episodes and worse graft function. The efficiency of desensitization using cascade plasma filtration and low-dose intravenous immunoglobulin is higher than that with high-dose intravenous immunoglobulin.
authors.affiliation: M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia.
authors.forename: A V
authors.initials: AV
authors.lastname: Vatazin
authors.affiliation: M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia.
authors.forename: A B
authors.initials: AB
authors.lastname: Zulkarnaev
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy / Q000379:methods; D003888:Desensitization, Immunologic / Q000379:methods; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000276:immunology*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis / Q000379:methods / Q000706:statistics & numerical data; D011182:Postoperative Care / Q000379:methods; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents