Novel double-filtration plasmapheresis preserves fibrinogen while removing immunoglobulin-G antibodies before ABO blood type-incompatible kidney transplantation

Iwami, Daiki; Matsumoto, Takenao; Ono, Kota; Hotta, Kiyohiko; Ota, Minoru; Chiba, Yuki; Sasaki, Hajime; Hirose, Takayuki; Higuchi, Haruka; Takada, Yusuke; Iwahara, Naoya; Murai, Sachiyo; Shinohara, Nobuo

Novel double-filtration plasmapheresis preserves fibrinogen while removing immunoglobulin-G antibodies before ABO blood type-incompatible kidney transplantation

Iwami, Daiki; Matsumoto, Takenao; Ono, Kota et al.

Renal Replacement Therapy, 2021, 7(1), 60

Permalink : https://hdl.handle.net/2115/84390

このアイテムのアクセス数:466件（2026-03-07 13:54 集計）

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https://doi.org/10.1186/s41100-021-00379-z			2

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アクセス権	metadata only access
URI	https://hdl.handle.net/2115/84390
タイトル	Novel double-filtration plasmapheresis preserves fibrinogen while removing immunoglobulin-G antibodies before ABO blood type-incompatible kidney transplantation
著者	Iwami, Daiki ; Matsumoto, Takenao ; Ono, Kota ; Hotta, Kiyohiko ; Ota, Minoru ; Chiba, Yuki ; Sasaki, Hajime ; Hirose, Takayuki ; Higuchi, Haruka ; Takada, Yusuke ; Iwahara, Naoya ; Murai, Sachiyo ; Shinohara, Nobuo
e-Rad_Researcher 80581115 著者名 Iwami, Daiki
著者名 Matsumoto, Takenao
著者名 Ono, Kota
e-Rad_Researcher 90443936 著者名 Hotta, Kiyohiko
著者名 Ota, Minoru
著者名 Chiba, Yuki
著者名 Sasaki, Hajime
著者名 Hirose, Takayuki
著者名 Higuchi, Haruka
著者名 Takada, Yusuke
著者名 Iwahara, Naoya
著者名 Murai, Sachiyo
e-Rad_Researcher 90250422 著者名 Shinohara, Nobuo
言語	英語
キーワード	ABO-incompatible
	Antibody removal
	Double-filtration plasmapheresis
	Kidney transplantation
発行日	2021-10-26
出版者	BioMed Central
収録物名	Renal Replacement Therapy
巻(号)	7(1)
ページ	60
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1186/s41100-021-00379-z