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Hokkaido University Collection of Scholarly and Academic Papers >
Graduate School of Medicine / Faculty of Medicine >
Peer-reviewed Journal Articles, etc >
Novel double-filtration plasmapheresis preserves fibrinogen while removing immunoglobulin-G antibodies before ABO blood type-incompatible kidney transplantation
| Title: | Novel double-filtration plasmapheresis preserves fibrinogen while removing immunoglobulin-G antibodies before ABO blood type-incompatible kidney transplantation |
| Authors: | Iwami, Daiki Browse this author →KAKEN DB | | Matsumoto, Takenao Browse this author | | Ono, Kota Browse this author | | Hotta, Kiyohiko Browse this author →KAKEN DB | | Ota, Minoru Browse this author | | Chiba, Yuki Browse this author | | Sasaki, Hajime Browse this author | | Hirose, Takayuki Browse this author | | Higuchi, Haruka Browse this author | | Takada, Yusuke Browse this author | | Iwahara, Naoya Browse this author | | Murai, Sachiyo Browse this author | | Shinohara, Nobuo Browse this author →KAKEN DB |
| Keywords: | ABO-incompatible | | Antibody removal | | Double-filtration plasmapheresis | | Kidney transplantation |
| Issue Date: | 26-Oct-2021 |
| Publisher: | BioMed Central |
| Journal Title: | Renal Replacement Therapy |
| Volume: | 7 |
| Issue: | 1 |
| Start Page: | 60 |
| Publisher DOI: | 10.1186/s41100-021-00379-z |
| Abstract: | Background Removal of anti-blood group antibodies is important for successful ABO-incompatible kidney transplantation (ABOi-KTx). Double-filtration plasmapheresis (DFPP) using albumin solution removes antibodies effectively. However, fibrinogen is largely removed resulting in hemostatic failure. Herein, we designed an altered combination of plasma membranes in DFPP (novel DFPP, nDFPP) to retain more fibrinogen while removing IgG, and assessed its efficacy and safety compared with conventional DFPP (cDFPP). Methods Consecutive ABOi-KTx recipients (from 2015 to 2018) were enrolled. For the first membrane, we used Cascadeflo EC-50W in nDFPP and Plasmaflo OP-08W in cDFPP, and Cascadeflo EC-20W as the second membrane in both modalities. Removal rates (RR) of IgG, IgM and fibrinogen per DFPP session, and adverse events were compared with historical control patients who underwent cDFPP before ABOi-KTx, between 2006 and 2015. Results nDFPP and cDFPP groups included 12 and 23 cases, respectively. nDFPP was inferior to cDFPP in RR of IgG and IgM. nDFPP was also inferior to cDFPP in the decline in anti-blood group IgG and IgM antibody titers. However, fibrinogen was more preserved in nDFPP compared with cDFPP, indicating that nDFPP has more selective removal properties (median RR of IgG, IgM, and fibrinogen: 62.1%, 15.7% and 37.6%, respectively, in nDFPP; and 74.5%, 85.0% and 76.6%, respectively, in cDFPP). In the comparison of hemostatic function among the patients who had arteriovenous fistula for hemodialysis, prolonged hemostasis (> 20 min) at the cannulation site was significantly less frequently observed in nDFPP group (1 in 9 cases, 9.1%) than in cDFPP group (all 18 cases, 10%, p < 0.0001). Conclusions nDFPP preserves fibrinogen while removing anti-blood type IgG antibodies before ABOi-KTx. |
| Type: | article |
| URI: | http://hdl.handle.net/2115/84390 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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