Repository for Antibody Incompatible Transplantation Evidence

[Immunoadsorption of anti-HLA antibodies on protein A-sepharose columns in hyperimmunized recipients waiting for transplantation].

Ann Med Interne (Paris). 1994;145(5):324-7.

In an attempt to reduce anti-HLA immunization in 15 patients awaiting for renal grafts and who were immunized against 65% of a panel of lymphocytes (titre 1/8 to 1/128), were given 5 to 7 sessions of immunoadsorption on protein A columns, immunosuppressor drugs (corticosteroids: 1 mg/kg/day + cyclophosphamid: 2 mg/kg/day) and intravenous polyclonal immunoglobulins. The antibody titres decreased in all patients, but this protocol did not sufficiently block resynthesis of antibodies. Among the 12 patients who were transplanted, the graft functioned correctly in 8 after a follow-up of 3 months to 3 years. Three early graft failures occurred in the group of 5 patients whose had had a positive cross-match before treatment. This treatment did not appear to increase the frequency of infectious complications immediately after transplantation.

LEVEL OF EVIDENCE: Case Series / Case Control / Cohort
MESH HEADINGS: Adult; Female; Graft Rejection / immunology; Graft Rejection / prevention & control; HLA Antigens / immunology*; Humans; Immunoglobulin G*; Immunoglobulins, Intravenous / therapeutic use; Immunosorbent Techniques*; Immunosuppression Therapy; Immunosuppressive Agents / therapeutic use; Kidney Transplantation*; Kidney Transplantation / adverse effects; Kidney Transplantation / mortality; Male; Middle Aged; Plasmapheresis*; Preoperative Care; Sepharose; Staphylococcal Protein A