Plasmapheresis in a Renal Transplant Patient with Positive Crossmatch only Detected by Flow Cytometry / 대한수혈학회지

ABSTRACT

Complement-dependent cytotoxicity (CDC) has been established as a crossmatch (XM) technique that can effectively prevent hyperacute transplantation rejetion by detecting preformed complement-fixing antibodies. The anti-human globulin crossmatch (AHGXM) has been performed in an effort to improve sensitivity for detecting anti-donor antibodies. Flow cytometry crossmatch (FCXM) was introduced as a more sensitive technique than the traditional CDCXM or AHGXM. A positive pre-transplant FCXM in recipients with a negative CDCXM or AHGXM has been found to be associated with a poor graft survival in several studies. Many clinical studies have focused on suppressing or eliminating anti-donor antibodies through the use of immunosuppresive drugs, immunoadsorption, intravenous immunoglobulin, or plasmapheresis. We performed plasmapheresis with intravenous immunoglobulin and FK 506 for a 38-year old female patient with chronic renal failure to remove anti-donor antibody which was only detected by FCXM. After transplant, no evidence of hyperacute or acute rejection was found. After 6 month, the recipient was surviving with well-functioning graft.