Application of plasmapheresis in perioperative period of kidney transplantation_West China Medical Journal

Authors：

YIN Supei ,  ZHANG Keqin

Urinary Nephropathy Center, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400072, P. R. China;

Corresponding author：

ZHANG Keqin, Email: zhkq2000@sina.com

Keywords：

End-stage renal disease; kidney transplantation; plasmapheresis; plasma exchange

DOI：

10.7507/1002-0179.202206147

Video：

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Kidney transplantation is an ideal treatment for patients with end-stage renal disease. Circulating alloantibodies against donor human leukocyte antigens and blood group antigens can impair allografts, shorten allograft survival, and limit access to kidney transplantation. Furthermore, the presence of donor specific antibodies is associated with increased incidence of antibody-mediated rejection and decreased graft survival following transplantation. Plasmapheresis, an extracorporeal therapy directed at removing plasma proteins that has been found to minimize the effects of perioperative sensitization in kidney transplantation. Plasmapheresis enables transplantation across the barrier of ABO blood group incompatibility. In addition, it is also an important approach for the treatment of antibody-mediated rejection. Therefore, studying the application of plasmapheresis in perioperative period of kidney transplantation is expected to increase the chance of transplantation and improve the outcomes following transplantation. This article introduces the application of plasmapheresis in the perioperative period of kidney transplantation.

Citation： YIN Supei, ZHANG Keqin. Application of plasmapheresis in perioperative period of kidney transplantation. West China Medical Journal, 2022, 37(7): 984-988. doi: 10.7507/1002-0179.202206147 Copy

1.	Knoll G. Trends in kidney transplantation over the past decade. Drugs, 2008, 68(Suppl 1): 3-10.
2.	Wolfe RA, Ashby VB, Milford EL, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med, 1999, 341(23): 1725-1730.
3.	Henderson ML, Thomas AG, Shaffer A, et al. The national landscape of living kidney donor follow-up in the United States. Am J Transplant, 2017, 17(12): 3131-3140.
4.	Stewart DE, Klassen DK. Kidney transplants from HLA-incompatible live donors and survival. N Engl J Med, 2016, 375(3): 287-288.
5.	Starzl TE, Marchioro TL, Holmes JH, et al. Renal homografts in patients with major donor-recipient blood group incompatibilities. Surgery, 1964, 55: 195-200.
6.	Maritati F, Bini C, Cuna V, et al. Current perspectives in ABO-incompatible kidney transplant. J Inflamm Res, 2022, 15: 3095-3103.
7.	Padmanabhan A, Connelly-Smith L, Aqui N, et al. Guidelines on the use of therapeutic apheresis in clinical practice - evidence-based approach from the Writing Committee of the American Society for Apheresis: the eighth special issue. J Clin Apher, 2019, 34(3): 171-354.
8.	George SM, Balogun RA, Sanoff SL. Therapeutic apheresis before and after kidney transplantation. J Clin Apher, 2011, 26(5): 252-260.
9.	Genberg H, Kumlien G, Wennberg L, et al. Isoagglutinin adsorption in ABO-incompatible transplantation. Transfus Apher Sci, 2010, 43(2): 231-235.
10.	Cen M, Wang R, Kong W, et al. ABO-incompatible living kidney transplantation. Clin Transplant, 2020, 34(9): e14050.
11.	Vo AA, Peng A, Toyoda M, et al. Use of intravenous immune globulin and rituximab for desensitization of highly HLA-sensitized patients awaiting kidney transplantation. Transplantation, 2010, 89(9): 1095-1102.
12.	Böhmig GA, Farkas AM, Eskandary F, et al. Strategies to overcome the ABO barrier in kidney transplantation. Nat Rev Nephrol, 2015, 11(12): 732-747.
13.	Vo AA, Lukovsky M, Toyoda M, et al. Rituximab and intravenous immune globulin for desensitization during renal transplantation. N Engl J Med, 2008, 359(3): 242-251.
14.	Mai ML, Ahsan N, Wadei HM, et al. Excellent renal allograft survival in donor-specific antibody positive transplant patients-role of intravenous immunoglobulin and rabbit antithymocyte globulin. Transplantation, 2009, 87(2): 227-232.
15.	Morath C, Zeier M, Döhler B, et al. ABO-incompatible kidney transplantation. Front Immunol, 2017, 8: 234.
16.	Alexandre GP, Squifflet JP, De Bruyère M, et al. Present experiences in a series of 26 ABO-incompatible living donor renal allografts. Transplant Proc, 1987, 19(6): 4538-4542.
17.	Hatakeyama S, Fujita T, Murakami R, et al. Outcome comparison of ABO-incompatible kidney transplantation with low-dose rituximab and ABO-compatible kidney transplantation: a single-center experience. Transplant Proc, 2014, 46(2): 445-448.
18.	Scurt FG, Ewert L, Mertens PR, et al. Clinical outcomes after ABO-incompatible renal transplantation: a systematic review and meta-analysis. Lancet, 2019, 393(10185): 2059-2072.
19.	Aikawa A. Current status and future aspects of kidney transplantation in Japan. Ren Replace Ther, 2018, 4: 50.
20.	Tanabe K. Double-filtration plasmapheresis. Transplantation, 2007, 84(Suppl 12): S30-S32.
21.	Biglarnia AR, Nilsson B, Nilsson Ekdahl K, et al. Desensitization with antigen-specific immunoadsorption interferes with complement in ABO-incompatible kidney transplantation. Transplantation, 2012, 93(1): 87-92.
22.	Schiesser M, Steinemann DC, Hadaya K, et al. The reuse of immunoadsorption columns in ABO-incompatible kidney transplantation is efficient: the Swiss experience. Transplantation, 2015, 99(5): 1030-1035.
23.	Barnett AN, Manook M, Nagendran M, et al. Tailored desensitization strategies in ABO blood group antibody incompatible renal transplantation. Transpl Int, 2014, 27(2): 187-196.
24.	Speer C, Kälble F, Nusshag C, et al. Outcomes and complications following ABO-incompatible kidney transplantation performed after desensitization by semi-selective immunoadsorption - a retrospective study. Transpl Int, 2019, 32(12): 1286-1296.
25.	Okumi M, Toki D, Nozaki T, et al. ABO-incompatible living kidney transplants: evolution of outcomes and immunosuppressive management. Am J Transplant, 2016, 16(3): 886-896.
26.	Kohei N, Hirai T, Omoto K, et al. Chronic antibody-mediated rejection is reduced by targeting B-cell immunity during an introductory period. Am J Transplant, 2012, 12(2): 469-476.
27.	Subramanian V, Gunasekaran M, Gaut JP, et al. ABO incompatible renal transplants and decreased likelihood for developing immune responses to HLA and kidney self-antigens. Hum Immunol, 2016, 77(1): 76-83.
28.	Hart A, Smith JM, Skeans MA, et al. OPTN/SRTR 2015 annual data report: kidney. Am J Transplant, 2017, 17(Suppl 1): 21-116.
29.	Davis S, Cooper JE. Acute antibody-mediated rejection in kidney transplant recipients. Transplant Rev (Orlando), 2017, 31(1): 47-54.
30.	Stegall MD, Gloor JM. Deciphering antibody-mediated rejection: new insights into mechanisms and treatment. Curr Opin Organ Transplant, 2010, 15(1): 8-10.
31.	Lefaucheur C, Nochy D, Andrade J, et al. Comparison of combination plasmapheresis/IVIg/anti-CD20 versus high-dose IVIg in the treatment of antibody-mediated rejection. Am J Transplant, 2009, 9(5): 1099-1107.
32.	Briganti EM, Russ GR, McNeil JJ, et al. Risk of renal allograft loss from recurrent glomerulonephritis. N Engl J Med, 2002, 347(2): 103-109.
33.	Sever S, Trachtman H, Wei C, et al. Is there clinical value in measuring suPAR levels in FSGS?. Clin J Am Soc Nephrol, 2013, 8(8): 1273-1275.
34.	Wei C, El Hindi S, Li J, et al. Circulating urokinase receptor as a cause of focal segmental glomerulosclerosis. Nat Med, 2011, 17(8): 952-960.
35.	Bock ME, Price HE, Gallon L, et al. Serum soluble urokinase-type plasminogen activator receptor levels and idiopathic FSGS in children: a single-center report. Clin J Am Soc Nephrol, 2013, 8(8): 1304-1311.
36.	Davenport RD. Apheresis treatment of recurrent focal segmental glomerulosclerosis after kidney transplantation: re-analysis of published case-reports and case-series. J Clin Apher, 2001, 16(4): 175-178.
37.	Matalon A, Markowitz GS, Joseph RE, et al. Plasmapheresis treatment of recurrent FSGS in adult renal transplant recipients. Clin Nephrol, 2001, 56(4): 271-278.
38.	Deegens JK, Andresdottir MB, Croockewit S, et al. Plasma exchange improves graft survival in patients with recurrent focal glomerulosclerosis after renal transplant. Transpl Int, 2004, 17(3): 151-157.
39.	Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant, 2009, 9(Suppl 3): S1-S155.

1. Knoll G. Trends in kidney transplantation over the past decade. Drugs, 2008, 68(Suppl 1): 3-10.
2. Wolfe RA, Ashby VB, Milford EL, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med, 1999, 341(23): 1725-1730.
3. Henderson ML, Thomas AG, Shaffer A, et al. The national landscape of living kidney donor follow-up in the United States. Am J Transplant, 2017, 17(12): 3131-3140.
4. Stewart DE, Klassen DK. Kidney transplants from HLA-incompatible live donors and survival. N Engl J Med, 2016, 375(3): 287-288.
5. Starzl TE, Marchioro TL, Holmes JH, et al. Renal homografts in patients with major donor-recipient blood group incompatibilities. Surgery, 1964, 55: 195-200.
6. Maritati F, Bini C, Cuna V, et al. Current perspectives in ABO-incompatible kidney transplant. J Inflamm Res, 2022, 15: 3095-3103.
7. Padmanabhan A, Connelly-Smith L, Aqui N, et al. Guidelines on the use of therapeutic apheresis in clinical practice - evidence-based approach from the Writing Committee of the American Society for Apheresis: the eighth special issue. J Clin Apher, 2019, 34(3): 171-354.
8. George SM, Balogun RA, Sanoff SL. Therapeutic apheresis before and after kidney transplantation. J Clin Apher, 2011, 26(5): 252-260.
9. Genberg H, Kumlien G, Wennberg L, et al. Isoagglutinin adsorption in ABO-incompatible transplantation. Transfus Apher Sci, 2010, 43(2): 231-235.
10. Cen M, Wang R, Kong W, et al. ABO-incompatible living kidney transplantation. Clin Transplant, 2020, 34(9): e14050.
11. Vo AA, Peng A, Toyoda M, et al. Use of intravenous immune globulin and rituximab for desensitization of highly HLA-sensitized patients awaiting kidney transplantation. Transplantation, 2010, 89(9): 1095-1102.
12. Böhmig GA, Farkas AM, Eskandary F, et al. Strategies to overcome the ABO barrier in kidney transplantation. Nat Rev Nephrol, 2015, 11(12): 732-747.
13. Vo AA, Lukovsky M, Toyoda M, et al. Rituximab and intravenous immune globulin for desensitization during renal transplantation. N Engl J Med, 2008, 359(3): 242-251.
14. Mai ML, Ahsan N, Wadei HM, et al. Excellent renal allograft survival in donor-specific antibody positive transplant patients-role of intravenous immunoglobulin and rabbit antithymocyte globulin. Transplantation, 2009, 87(2): 227-232.
15. Morath C, Zeier M, Döhler B, et al. ABO-incompatible kidney transplantation. Front Immunol, 2017, 8: 234.
16. Alexandre GP, Squifflet JP, De Bruyère M, et al. Present experiences in a series of 26 ABO-incompatible living donor renal allografts. Transplant Proc, 1987, 19(6): 4538-4542.
17. Hatakeyama S, Fujita T, Murakami R, et al. Outcome comparison of ABO-incompatible kidney transplantation with low-dose rituximab and ABO-compatible kidney transplantation: a single-center experience. Transplant Proc, 2014, 46(2): 445-448.
18. Scurt FG, Ewert L, Mertens PR, et al. Clinical outcomes after ABO-incompatible renal transplantation: a systematic review and meta-analysis. Lancet, 2019, 393(10185): 2059-2072.
19. Aikawa A. Current status and future aspects of kidney transplantation in Japan. Ren Replace Ther, 2018, 4: 50.
20. Tanabe K. Double-filtration plasmapheresis. Transplantation, 2007, 84(Suppl 12): S30-S32.
21. Biglarnia AR, Nilsson B, Nilsson Ekdahl K, et al. Desensitization with antigen-specific immunoadsorption interferes with complement in ABO-incompatible kidney transplantation. Transplantation, 2012, 93(1): 87-92.
22. Schiesser M, Steinemann DC, Hadaya K, et al. The reuse of immunoadsorption columns in ABO-incompatible kidney transplantation is efficient: the Swiss experience. Transplantation, 2015, 99(5): 1030-1035.
23. Barnett AN, Manook M, Nagendran M, et al. Tailored desensitization strategies in ABO blood group antibody incompatible renal transplantation. Transpl Int, 2014, 27(2): 187-196.
24. Speer C, Kälble F, Nusshag C, et al. Outcomes and complications following ABO-incompatible kidney transplantation performed after desensitization by semi-selective immunoadsorption - a retrospective study. Transpl Int, 2019, 32(12): 1286-1296.
25. Okumi M, Toki D, Nozaki T, et al. ABO-incompatible living kidney transplants: evolution of outcomes and immunosuppressive management. Am J Transplant, 2016, 16(3): 886-896.
26. Kohei N, Hirai T, Omoto K, et al. Chronic antibody-mediated rejection is reduced by targeting B-cell immunity during an introductory period. Am J Transplant, 2012, 12(2): 469-476.
27. Subramanian V, Gunasekaran M, Gaut JP, et al. ABO incompatible renal transplants and decreased likelihood for developing immune responses to HLA and kidney self-antigens. Hum Immunol, 2016, 77(1): 76-83.
28. Hart A, Smith JM, Skeans MA, et al. OPTN/SRTR 2015 annual data report: kidney. Am J Transplant, 2017, 17(Suppl 1): 21-116.
29. Davis S, Cooper JE. Acute antibody-mediated rejection in kidney transplant recipients. Transplant Rev (Orlando), 2017, 31(1): 47-54.
30. Stegall MD, Gloor JM. Deciphering antibody-mediated rejection: new insights into mechanisms and treatment. Curr Opin Organ Transplant, 2010, 15(1): 8-10.
31. Lefaucheur C, Nochy D, Andrade J, et al. Comparison of combination plasmapheresis/IVIg/anti-CD20 versus high-dose IVIg in the treatment of antibody-mediated rejection. Am J Transplant, 2009, 9(5): 1099-1107.
32. Briganti EM, Russ GR, McNeil JJ, et al. Risk of renal allograft loss from recurrent glomerulonephritis. N Engl J Med, 2002, 347(2): 103-109.
33. Sever S, Trachtman H, Wei C, et al. Is there clinical value in measuring suPAR levels in FSGS?. Clin J Am Soc Nephrol, 2013, 8(8): 1273-1275.
34. Wei C, El Hindi S, Li J, et al. Circulating urokinase receptor as a cause of focal segmental glomerulosclerosis. Nat Med, 2011, 17(8): 952-960.
35. Bock ME, Price HE, Gallon L, et al. Serum soluble urokinase-type plasminogen activator receptor levels and idiopathic FSGS in children: a single-center report. Clin J Am Soc Nephrol, 2013, 8(8): 1304-1311.
36. Davenport RD. Apheresis treatment of recurrent focal segmental glomerulosclerosis after kidney transplantation: re-analysis of published case-reports and case-series. J Clin Apher, 2001, 16(4): 175-178.
37. Matalon A, Markowitz GS, Joseph RE, et al. Plasmapheresis treatment of recurrent FSGS in adult renal transplant recipients. Clin Nephrol, 2001, 56(4): 271-278.
38. Deegens JK, Andresdottir MB, Croockewit S, et al. Plasma exchange improves graft survival in patients with recurrent focal glomerulosclerosis after renal transplant. Transpl Int, 2004, 17(3): 151-157.
39. Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant, 2009, 9(Suppl 3): S1-S155.

West China Medical Journal

Application of plasmapheresis in perioperative period of kidney transplantation

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