Korean J Blood Transfus.  2016 Apr;27(1):22-30. 10.17945/kjbt.2016.27.1.22.

Initial ABO Antibody Titer as a Variable for Estimating Number of Therapeutic Plasma Exchange prior to ABO Incompatible Kidney Transplantation

• Kim J
• Kim S
• Kim MS
• Kim YS
• Kim HO

• KMID: 2163117
• DOI: http://doi.org/10.17945/kjbt.2016.27.1.22

Abstract

BACKGROUND
Therapeutic plasma exchange (TPE) for desensitization in ABO incompatible kidney transplantation (KT) has raised concerns regarding efficiency and safety. The purpose of this study was to determine the number of TPE prior to KT required to reach target titer for KT according to ABO blood groups.
METHODS
The distribution of ABO antibody (Ab) titer of 117 patients was investigated. The relationship between initial ABO Ab and number of TPEs required to reach target titer to ≤1:8 prior to KT was evaluated retrospectively according to blood groups and ABO Ab classes.
RESULTS
The initial IgG ABO Ab titers were the highest in blood O group recipients, and the average number±standard deviations (range) of TPEs performed prior to ABO incompatible KT was 3.0±1.1 (0~5) in blood group A, 3.7±1.5 (0~8) in blood group B, and 5.3±1.9 (2~13) in blood group O, respectively. The best correlation was observed in the linear relationship between initial ABO Ab titer and number of TPEs required (y=0.6829x+0.0523, R2=0.946, x=log2 initial ABO Ab titer, y=number of TPE required), regardless of the specific ABO blood group.
CONCLUSION
The number of TPEs can be highly deduced from initial ABO Ab titer and our developed equation in desensitization programs would help increase the efficiency of TPE and patient safety.

Keyword

Plasma exchange; Blood group incompatibility; Kidney transplantation; ABO antibodies

MeSH Terms

Blood Group Antigens
Blood Group Incompatibility
Humans
Immunoglobulin G
Kidney Transplantation*
Kidney*
Patient Safety
Plasma Exchange*
Plasma*
Retrospective Studies
Blood Group Antigens
Immunoglobulin G