Protein A immunoadsorption for acute rejection following renal transplantation in 12 highly sensitized recipients / 中国组织工程研究

ABSTRACT

To investigate the preventive and treated effects of protein A immunoadsorption on hyperacute rejection of highly sensitized renal transplant recipient. A total of 12 highly sensitized renal transplant recipients were selected from Department of Organ Transplantation, Zhengzhou People's Hospital between January 2006 and January 2008. Immunoadsorption treatment was performed on 12 renal transplant recipients whose panel reactive antigen was more than 50% once a week for 4-6 weeks before operation. At one day before operation, the treatment was performed once. The treatment was performed at once if the acute rejection occurred after operation. The acute rejection and adverse effect were observed. Hyperacute rejection was not occurred in any recipient. Sudden oliguria and increase of serum creatinine were occurred in two cases at several days after operation. The pathological examination showed there were inflammatory cells infiltration and edema in renal interstitial, lymphocyte aggregation around renal tubular, monocytes infiltration in capillary, endarteritis, and necrosis of small vessels in the two cases. They were diagnosed as acute rejection. Their panel reactive antibody level increased again. Average level of Class Ⅰ was 3.8% and class Ⅱ was 19.2%. Acute rejection were reversed and renal function recovered to normal by the therapy of protein A immunoadsorption and pulse therapy of high dose methylprednisolone. Average level of Class Ⅰ was 8.3% and class Ⅱ was 5.2%. One year follow-up were obtained from all recipients. Their transplanted renal function were good, which suggested protein A immunoadsorptin could eliminate antibody in recipients quickly, decrease panel reactive antibody level, and prevent acute rejection.