Preoperative therapeutic plasma exchange to prevent acute rejection after ABO incompatible renal transplantation: a retrospective analysis
Journal Title: Chinese Journal of Blood Transfusion - Year 2024, Vol 37, Issue 7
Abstract
Objective To investigate the clinical efficacy of preoperative therapeutic plasma exchange(TPE) in preventing acute rejection after ABO incompatible kidney transplantation(ABOi-KT). Methods Nine patients with ABOi-KT who were admitted to the renal transplant department of our hospital from April 2022 to April 2024 were retrospectively analyzed. They received a total of 28 TPEs before kidney transplantation, and the treatment plan was summarized as follows: The proportion of the substitute fluid, as well as the frequency and volume of TPE were determined based on the patient′s ABO blood group system antibody titer, gender, height, weight, hematocrit and other indicators upon admission. The patient′s relevant laboratory indicators, including hemoglobin, platelets, leukocytes, coagulation function, total protein, albumin, globulin, A/G, creatinine and urea nitrogen upon admission and after TPE were monitored and statistically analyzed. After transplantation, changes in renal function indicators such as ABO blood group system antibody titers, creatinine and urinary excretion were observed, and clinical symptoms of acute rejection, such as swelling, pain and edema in the transplanted kidney area were observed. Results Nine ABOi-KT patients had an average of about 3 TPEs before transplantation surgery, with an average total volume of approximately 2 500 mL to 3 500 mL per TPE, or approximately about 1.01 to 1.16 plasma volume (PV). After multiple TPEs, pre-transplantation antibody titers decreased by an average of 3 times compared to before TPE. There were no statistically significant differences in Hb, PLT, PT, PTA, INR, TBil, ALB, Cr and BUN (P>0.05), while statistically significant differences were found in WBC, APTT, Fbg, TP, GLB and A/G (P<0.05). After surgery, the creatinine level of 9 patients dropped to approximately 100 to 140 μmol/L, the urine output was normal, and the urine protein dropped to weakly positive or negative values. None of the nine patients experienced acute rejection. Conclusion TPE can effectively reduce the level of ABO blood group antibody and prevent the occurrence of acute rejection in ABOi-KT patients.
Authors and Affiliations
Xinran LIU, Dan WANG, Ruirui SU, Yiming MA, Xiaofei LI, Yang YU
Keywords
Related Articles
- EP ID EP742806
- DOI 10.13303/j.cjbt.issn.1004-549x.2024.07.003
- Views 35
- Downloads 0
Screening and clinical significance of intestinal colonization of carbapenem-resistant Enterobacteriaceae (CRE) in patients before haploidentical hematopoietic stem cell transplantation
Objective To investigate the situation of carbapenem-resistant Enterobacteriaceae(CRE) colonization in patients undergoing haploidentical hematopoietic stem cell transplantation (haplo-HSCT). Methods A total of 241 conse...
Preoperative therapeutic plasma exchange to prevent acute rejection after ABO incompatible renal transplantation: a retrospective analysis
Objective To investigate the clinical efficacy of preoperative therapeutic plasma exchange(TPE) in preventing acute rejection after ABO incompatible kidney transplantation(ABOi-KT). Methods Nine patients with ABOi-KT who...
Removing the interference of daratumumab on transfusion compatibility testing and transfusion efficacy comparison
Objective To explore the feasibility of blood transfusion compatibility testing for multiple myeloma(MM) patients treated with anti-CD38 monoclonal antibody daratumumab (DARA) after DARA-Fab fragment blocking, and to eva...
Risk factors of allergic reactions caused by therapeutic plasma exchange: a single-center analysis
Objective To review the occurrence of allergic reactions during therapeutic plasma exchange (TPE) and to explore the risk factors of TPE allergic reactions. Methods The clinical data of 929 patients treated with TPE usin...
Establishment of the maximum surgical blood order schedule for cesarean sections
Objective To establish the catalog of maximum surgical blood order schedule(MSBOS) for cesarean sections with different obstetric complications, so as to guide the doctors of clinical and Blood Transfusion Department to...