Modulating alloimmune responses with plasmapheresis and IVIG

Daniel S. Warren, Christopher E. Simpkins, Matthew Cooper, Robert A. Montgomery

Research output: Contribution to journalReview article

Abstract

Antibody-mediated barriers to renal transplantation, including donor specific anti-HLA and anti-blood group antibodies, have become an increasingly important issue over the last forty years as the organ shortage has continued to expand. The inevitable result of the unmet demand for compatible organs has been a continuous increase in recipient waiting times. Over the last decade, two treatment strategies have been developed to address this problem. These regimens rely on the immunomodulatory properties of intravenous immunoglobulin (IVIG) administered alone at relatively high doses, or at lower doses in combination with the non-selective depletion of antibodies from plasmapheresis. Both protocols have been successfully used for desensitization of patients with donor-specific anti-HLA antibody and have allowed for renal transplantation with excellent outcomes. The combined strategy of plasmapheresis/IVIG has also been successfully employed for renal transplantation in recipients of ABO blood group incompatible kidneys. This review will provide an overview of these therapies and their application to incompatible renal transplantation.

Original languageEnglish (US)
Pages (from-to)215-222
Number of pages8
JournalCurrent Drug Targets - Cardiovascular and Haematological Disorders
Volume5
Issue number3
DOIs
StatePublished - Jun 1 2005

Keywords

  • ABO incompatible
  • Desensitization
  • Intravenous immunoglobulin
  • Plasmapheresis
  • Positive crossmatch
  • Renal transplantation

ASJC Scopus subject areas

  • Molecular Medicine
  • Hematology
  • Pharmacology
  • Cardiology and Cardiovascular Medicine

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