Korean J Lab Med.  2003 Dec;23(6):439-442.

HLA Cross-match Negative Conversion by Therapeutic Plasmapheresis in a Patient with Positive HLA Cross-match

• Kim HR
• Lee JN
• Kim YH

Abstract

It is well accepted that kidney transplantation cannot be done if the recipient has antibodies showing a positive HLA cross-match to the donor. Recently, Schweitzer and his associates used a combination therapy with plasmapheresis, IV gamma globulin, and potent immunosuppression to induce HLA cross-match negative conversion in patients with a positive HLA cross-match to living donors and they reported good results after the trials. Therefore, we treated a patient with combination therapy who had persistent-positive HLA cross-match to multiple living donors. The patient was a 38-year-old female suffering from chronic renal failure and she showed persistent positive HLA cross-match to multiple living donors. Using a combination therapy with plasmapheresis, IV gamma globulin and immunosuppression, we have successfully achieved a HLA cross-match negative conversion in a patient and we did kidney transplantation without any sign of hyperacute or acute rejection. Although we present possibility of a HLA cross-match negative conversion by combination therapy, especially in a recipient with a low titer cross-match positive to a family donor, further long-term study with more patients is needed for evaluation of the efficacy of this trial.

Keyword

Positive HLA cross-match; Plasmapheresis; IV gamma-globulin; Immunosuppression

MeSH Terms

Adult
Antibodies
Female
gamma-Globulins
Humans
Immunosuppression
Kidney Failure, Chronic
Kidney Transplantation
Living Donors
Plasmapheresis*
Tissue Donors
Antibodies
gamma-Globulins