Kidney Res Clin Pract.  2017 Jun;36(2):192-199. 10.23876/j.krcp.2017.36.2.192.

Clinical analysis of single filtration plasmapheresis using continuous renal replacement therapy machines in kidney transplantation

• Lim E
• Kim Y
• Jeong JC
• Park I
• Kim H
• Lee SH
• Oh CK
• Shin GT

• KMID: 2384622
• DOI: http://doi.org/10.23876/j.krcp.2017.36.2.192

Abstract

BACKGROUND
Plasmapheresis has become an essential element of kidney transplantation (KT). In the present study, we report clinical outcomes of filtration plasmapheresis using continuous renal replacement therapy machines with a single filter for the first time in Korea.
METHODS
We retrospectively analyzed six patients who underwent filtration plasmapheresis for KT in our center; plasmapheresis was performed using the Plasmaflex (Baxter®) with a TPE 2000 filter set (Baxter®) in our hemodialysis unit. Five percent albumin was used as the replacement fluid, and intravenous immunoglobulin G was administered after each plasmapheresis session. The target preoperative ABO isoagglutinin titer was less than 1:8.
RESULTS
Filtration plasmapheresis was performed in four patients for ABO-incompatible KT, one for antibody-mediated rejection after KT, and the last one for positive T cell crossmatch. Altogether, 46 sessions of plasmapheresis were performed. ABO isoagglutinin titers successfully declined to or below the target level in all patients, and all patients successfully received KT with no significant antibody titer rebound. Acute antibody-mediated rejection and positive T cell crossmatch were well treated with filtration plasmapheresis, and no patient required fresh frozen plasma infusion for coagulopathy. There were one episode of hypotension and three of hypocalcemia. No patients experienced bleeding, infection, or allergic reaction.
CONCLUSION
Filtration plasmapheresis was effective and safe. Although our result is from a single center, our protocol appears to be promising.

Keyword

Filtration; Kidney transplantation; Plasmapheresis

MeSH Terms

Filtration*
Hemorrhage
Humans
Hypersensitivity
Hypocalcemia
Hypotension
Immunoglobulin G
Kidney Transplantation*
Kidney*
Korea
Plasma
Plasmapheresis*
Renal Dialysis
Renal Replacement Therapy*
Retrospective Studies
Immunoglobulin G