J.Jpn. Surg. Soc.. 91(9): 1272-1276, 1990

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Report on the annual meeting

EXTRACORPOREAL PLASMA TREATMENT FOR EXTENDING OPPORTUNITY OF KIDNEY TRANSPLANTATION；ABO-INCOMPATIBLE AND PREFORMED ANTIBODY-POSITIVE KIDNEY TRANSPLANTATION

In an effort to extend the opportunity of kidney transplantation, we treated the blood of recipients prior to transplantation by plasmapheresis and immunoadsorption in order to eliminate anti-A, anti-B antibodies or preformed antibodies and satisfactory clinical results were obtained.
(1) ABO-incompatible kidney transplantation
Ten kidney grafts from ABO-incompatible living related donors have been transplanted. Prior to the transplantation, double filtration plasmapheresis (DFPP) and immunoadsorption using a Biosynsorb Aor B immunoadsorption column were performed. A splenectomy was carried out before or after the transplantation. Five immunosuppressive agents were administered in the initial period. Kidney function has been maintained satisfactorily in all cases. after transplantation even with good function.
(2) Kidney transplantation in preformed antibody-positive recipients
DFPP and immunoadosorption were done in order to remove T-cell antibody. The immunosuppressant administration and the transplantation were carried out in a same manner as in ABO-incompatible cases. Good kidney function has been maintained for 1 to 20 months after transplantation in 6 cases. Kidney function was deteriorated because of hyperacute rejection in the remaining one case.
Conclusion
Extracorporeal plasma treatment was shown to be very effective in pneventing rejections in ABO-incompatible and preformed antibody-positive kidney transplantation and to be useful for extending opportunity of kidney transplantation

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