High dose of intravenous immunoglbulin in treatment of presensitized patients awaiting kidney transplantation patients / 第二军医大学学报

ABSTRACT

Objective: To investigate the effect of intravenous immunoglobulin in highly sensitized patients awaiting organ transplantation. Methods: IVIG was used to reduce donor specific anti HLA alloantibodies in vitro and in vivo . Fifteen patients received IVIG′s suppressive experiment in vitro by random panel lymphocytotoxicity test. The serum of patients were divided into 2 groups: one was diluted with equal volume of IVIG and the other was diluted with PBS solution, and then reacted with lymphocytes from healthy donors randomly. Of them 5 patients received the treatment by IVIG. Four patients were administrated with 0.5 g/kg. Period of treatment was 4 weeks. One patient received 8 weeks infusion in same dose, 2 patients resulted in PRA drop to 10% had received kidney and pancreas kidney transplantation. Results: The percentage of RPLT in experimental group was lower than that in control group. After large dose of infusion of IVIG, the patients showed a reduction in absolute PRA of 2% 51% (mean decrease: 23%). Two patients had undergone subsequent transplantation and no serious rejection occurred. Conclusion: Treatment with IVIG is a valuable tool for the transplantation of immunized patients. The effect of IVIG is dose dependent and can be achieved in 3 weeks.