HLA Cross-match Negative Conversion by Therapeutic Plasmapheresis in a Patient with Positive HLA Cross-match / 대한진단검사의학회지

ABSTRACT

It is well accepted that kidney transplantation cannot be done if the recipient has antibodies showing a positive HLA cross-match to the donor. Recently, Schweitzer and his associates used a combination therapy with plasmapheresis, IV gamma globulin, and potent immunosuppression to induce HLA cross-match negative conversion in patients with a positive HLA cross-match to living donors and they reported good results after the trials. Therefore, we treated a patient with combination therapy who had persistent-positive HLA cross-match to multiple living donors. The patient was a 38-year-old female suffering from chronic renal failure and she showed persistent positive HLA cross-match to multiple living donors. Using a combination therapy with plasmapheresis, IV gamma globulin and immunosuppression, we have successfully achieved a HLA cross-match negative conversion in a patient and we did kidney transplantation without any sign of hyperacute or acute rejection. Although we present possibility of a HLA cross-match negative conversion by combination therapy, especially in a recipient with a low titer cross-match positive to a family donor, further long-term study with more patients is needed for evaluation of the efficacy of this trial.