Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (40): 7444-7449.doi: 10.3969/j.issn.2095-4344.2012.40.007

Previous Articles     Next Articles

Desensitization of highly sensitized renal transplant recipients by plasmapheresis and intravenous immunoglobulin

Cheng Li1, Luo Zheng-mao2, Zhang Xiao-liang1   

  1. 1Department of Nephrology, the 180 Hospital of Chinese PLA, Quanzhou 362000, Fujian Province, China
    2Department of Nephrology, General Hospital of Guangzhuo Military Region of Chinese PLA, Guangzhou 510515, Guangdong Province, China
  • Received:2012-07-10 Revised:2012-08-09 Online:2012-09-30 Published:2012-09-30
  • About author:Cheng Li★, Master, Attending physician, Department of Nephrology, the 180 Hospital of Chinese PLA, Quanzhou 362000, Fujian Province, China CL20060606@sina.com

Abstract:

BACKGROUND: As there is no unified program about intravenous immunoglobulin in highly sensitized renal transplant recipients before transplantation, so it is not widely used in domestic.
OBJECTIVE: To evaluate the feasibility and efficacy of plasmapheresis plus low-dose intravenous immunoglobulin for the desensitization therapy of highly sensitized renal transplant recipients.
METHODS: Twenty-eight cases of renal transplant patients performed with human leukocyte antigen crossmatch and received plasmapheresis plus intravenous immunoglobulin, and then the rejection rate, graft survival time and functions of the transplanted kidney were observed.
RESULTS AND CONCLUSION: In desensitization group, no hyperacute acute occurred in the 28 desensitization patients. There were nine (32%) cases of acute rejection, including five (18%) cases of acute humoral rejection. All rejection episodes were reversed. With a follow-up of (50±24) months, the serum creatinine levels at 12 and 24 months were (112±18) μmol/L and (130±38) μmol/L, respectively. The survival rate at 12 and 48 months was 95.0% and 78.0% respectively. The desensitization therapy by plasmapheresis plus intravenous immunoglobulin is effective for highly sensitized renal transplant recipients. High rate of acute humoral rejection is the major defect of this protocol. The short-term graft survival rate after this protocol is acceptable but the long-term survival rate needs to be defined.

CLC Number: