PMID- 36621348
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240315
IS  - 2531-1387 (Electronic)
IS  - 2531-1379 (Print)
IS  - 2531-1379 (Linking)
VI  - 46
IP  - 1
DP  - 2024 Jan-Mar
TI  - Role of therapeutic plasma exchange as a desensitization therapy in human 
      leukocyte antigen incompatible renal transplant patients: A single-center 
      experience.
PG  - 42-48
LID - S2531-1379(22)01469-9 [pii]
LID - 10.1016/j.htct.2022.11.009 [doi]
AB  - OBJECTIVE: Despite an increase in the rate of successful live donor renal 
      transplantation done annually, the number of potential recipients with acceptable 
      donors is relegated to the ever-expanding cadaver-donor waiting list due to 
      sensitization to human leukocyte antigen (HLA) antibodies. If not sufficiently 
      suppressed, these preformed HLA antibodies can trigger antimicrobial resistance 
      (AMR) and early graft loss. To ameliorate this situation, various desensitization 
      treatments are administered to provide a survival benefit to highly sensitized 
      patients. METHOD: One hundred and six patients in the time frame of January 2017 
      to March 2019 were included in the study group. The desensitization protocol 
      included therapeutic plasma exchange and administration of low-dose intravenous 
      immunoglobulin (100 mg/kg per therapeutic plasma exchange (TPE) session) to 
      highly sensitized patients (treatment group) who subsequently underwent renal 
      transplantation after negative pre-transplant Centers for Disease Control and 
      Prevention Luminex crossmatch (CDC/LumXM). We compared graft survival rates 
      between the group undergoing desensitization (treatment group) and matched 
      control group of patients that underwent HLA-compatible transplantation. RESULTS: 
      In the treatment group, Kaplan-Meier analysis estimates an average rate of 
      patient graft survival of 95.2% at 3 years post-transplant, as compared with the 
      rate of 86.9% in the same time frame for the control-matched group (p < 0.05 for 
      both comparisons). CONCLUSION: Desensitization treatment with TPE before live 
      donor renal transplantation in the case of patients with HLA sensitization 
      provides better survival benefits along with monitoring for donor-specific 
      antibodies (DSAs) and other infections, rather than waiting for a compatible 
      organ donor. The data lays out evidence that desensitization treatments can 
      assist overcome HLA incompatibility barriers in live donor renal transplantation.
CI  - Copyright (c) 2022. Published by Elsevier Espana, S.L.U.
FAU - Chowdhry, Mohit
AU  - Chowdhry M
AD  - Department of Transfusion Medicine, Indraprastha Apollo Hospitals, Sarita Vihar, 
      Mathura Road, New Delhi 110076, India. Electronic address: 
      mohit_c@apollohospitals.com.
FAU - Yadav, Ayushi
AU  - Yadav A
AD  - Department of Transfusion Medicine, Indraprastha Apollo Hospitals, Sarita Vihar, 
      Mathura Road, New Delhi 110076, India.
FAU - Sharma, Vandana
AU  - Sharma V
AD  - Department of Transfusion Medicine, Indraprastha Apollo Hospitals, Sarita Vihar, 
      Mathura Road, New Delhi 110076, India.
FAU - Agrawal, Soma
AU  - Agrawal S
AD  - Department of Transfusion Medicine, Indraprastha Apollo Hospitals, Sarita Vihar, 
      Mathura Road, New Delhi 110076, India.
LA  - eng
PT  - Journal Article
DEP - 20221224
PL  - Brazil
TA  - Hematol Transfus Cell Ther
JT  - Hematology, transfusion and cell therapy
JID - 101725732
PMC - PMC10935460
OTO - NOTNLM
OT  - Desensitization
OT  - HLA incompatibility
OT  - TPE
COIS- Conflicts of interest None.
EDAT- 2023/01/10 06:00
MHDA- 2023/01/10 06:01
PMCR- 2022/12/24
CRDT- 2023/01/09 04:49
PHST- 2022/05/21 00:00 [received]
PHST- 2022/09/09 00:00 [revised]
PHST- 2022/11/16 00:00 [accepted]
PHST- 2023/01/10 06:01 [medline]
PHST- 2023/01/10 06:00 [pubmed]
PHST- 2023/01/09 04:49 [entrez]
PHST- 2022/12/24 00:00 [pmc-release]
AID - S2531-1379(22)01469-9 [pii]
AID - 10.1016/j.htct.2022.11.009 [doi]
PST - ppublish
SO  - Hematol Transfus Cell Ther. 2024 Jan-Mar;46(1):42-48. doi: 
      10.1016/j.htct.2022.11.009. Epub 2022 Dec 24.