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Enfermería Nefrológica

On-line version ISSN 2255-3517Print version ISSN 2254-2884

Abstract

BONACHE TUR, Débora et al. Results of immunoadsorption in the ABOi kidney transplantation and humoral rejection in a hospital hemodialysis unit. Enferm Nefrol [online]. 2018, vol.21, n.4, pp.386-392. ISSN 2255-3517.  http://dx.doi.org/10.4321/s2254-28842018000400008.

Introduction:

The non-selective immunoadsorption treatment was introduced in our hospital hemodialysis unit with the aim of allowing desensitization prior to a kidney transplant with blood group incompatibility and the treatment of antibody-mediated rejection.

Aim:

To analyze the results of the non-selective immunoadsorption technique in a hospital hemodialysis unit.

Material and methods:

Retrospective descriptive study of the first 18 patients treated in our center with non-selective immunoadsorption (years 2012-2017) in the indications for ABOi transplant conditioning and treatment of humoral rejection.

Results:

During a period of 5 years, 128 non-selective immunoadsorption sessions were analyzed. 38.9% (n= 7) of cases for desensitization prior to renal transplantation with incompatibility of blood group and 61.1% (n=11) remaining for the treatment of antibody-mediated rejection.

In the first case, an average of 8±0.6 sessions of immunoadsorption prior to kidney transplantation were performed and 57.1% were complemented by 2 subsequent sessions. The concomitant treatment was protocolled with rituximab and immunoglobulins, 57.1% requiring plasma exchanges. In the second case, an average of 5.9±2 immunoadsorption sessions were carried out. The concomitant treatment was the same and 27.3% performed plasma exchanges.

Conclusions:

Kidney transplantation from ABOi living donor after desensitization was possible in 100% of patients. 72.7% of patients treated for antibody-mediated rejection currently maintain graft functionality.

Keywords : kidney transplantation; blood group incompatibility; immunosorbent technique; desensitization; rituximab.

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