A case of successful desensitization using therapeutic plasma exchange in high-risk HLA incompatible kidney transplantation |
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| Institution: | 1. Transfusion Medicine & Blood Centre, Jaypee Hospital, Noida, Delhi NCR, India;2. Nephrology & Renal Transplant, Jaypee Hospital, Noida, Delhi NCR, India;3. Urology & Renal Transplant, Jaypee Hospital, Noida, Delhi NCR, India;1. Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA;2. Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA;3. Revivicor, Blacksburg, VA, USA;4. Department of Pediatric Cardiology, Division of Critical Care, University of Alabama at Birmingham, Birmingham, AL, USA;1. Medical Research Center, Affiliated Hospital of Jining Medical University, Jining, PR China;2. Institute of Immunology and Molecular Medicine, Jining Medical University, Jining, PR China;3. Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao, PR China;4. Jilin University No 3 Hospital, Jilin, PR China;5. Shanghai Meifeng Biotechnology Co., Ltd, Shanghai, PR China;6. Institute of Liver Diseases, Affiliated Hospital of Jining Medical University, Jining, PR China;1. Department of Geriatrics, The Second Affiliated Hospital of Hainan Medical University, No.48, Baishuitang Road, Haikou, Hainan Province 571000, China;2. Department of Cardiology, Qionghai Hospital of Traditional Chinese Medicine, Qionghai City, Hainan Province 571400, China |
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| Abstract: | Advances in immune suppression therapies and desensitization have made possible kidney transplantation regardless of HLA incompatibility. Single antigen bead assay (SAB) is a semi-quantitative estimation of the amount of human leukocyte antigen (HLA) antibodies present in the recipient plasma, and mean fluorescence intensity (MFI) generated gives this rough estimation of the antibodies present in the recipient. Here we present a case of successful kidney transplantation in a patient who expressed DSA with high MFI. A 33-yr-old male, diagnosed with chronic kidney disease (CKD) on regular maintenance hemodialysis, opted for second kidney transplant with his sibling as prospective donor and was referred to the department of Transplant Immunology for histocompatibility testing. Patient had HLA incompatibility with multiple DSA identified by SAB. Patient undergone 20 sessions of plasma exchange till discharge and finally till 6 months graft was functioning well. The authors thus conclude that the option of a high-risk HLA incompatible kidney transplant can be offered to recipients with high MFI DSA, who wish to undergo transplantation for end stage renal disease. |
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