Cascade plasmapheresis as a desensitization strategy for patients undergoing ABO incompatible living donor liver transplantation (ABOi LDLT): A single center experience
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Bajpai, Meenu
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Inst Liver & Biliary Sci, Dept Transfus Med, New Delhi 110070, IndiaInst Liver & Biliary Sci, Dept Transfus Med, New Delhi 110070, India
Bajpai, Meenu
[1
]
Kakkar, Brinda
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Inst Liver & Biliary Sci, Dept Transfus Med, New Delhi 110070, IndiaInst Liver & Biliary Sci, Dept Transfus Med, New Delhi 110070, India
Kakkar, Brinda
[1
]
Gupta, Shruti
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Inst Liver & Biliary Sci, Dept Transfus Med, New Delhi 110070, IndiaInst Liver & Biliary Sci, Dept Transfus Med, New Delhi 110070, India
Gupta, Shruti
[1
]
Rastogi, Archana
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Inst Liver & Biliary Sci, Dept Pathol, New Delhi 110070, IndiaInst Liver & Biliary Sci, Dept Transfus Med, New Delhi 110070, India
Rastogi, Archana
[2
]
Pamecha, Viniyendra
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Inst Liver & Bihar, Dept Liver Transplant Surg, New Delhi 110070, IndiaInst Liver & Biliary Sci, Dept Transfus Med, New Delhi 110070, India
Pamecha, Viniyendra
[3
]
机构:
[1] Inst Liver & Biliary Sci, Dept Transfus Med, New Delhi 110070, India
[2] Inst Liver & Biliary Sci, Dept Pathol, New Delhi 110070, India
[3] Inst Liver & Bihar, Dept Liver Transplant Surg, New Delhi 110070, India
Background and aim: The reduction of antibody titres (Ars) to a safe level is essential pre-requisite for patients awaiting ABO-incompatible liver transplantation (ABOi LT). We report our experience of performing cascade plasmapheresis (CP) on 2 different apheresis platforms (COBE Spectra and Spectra Optia) as a desensitization strategy for patients undergoing ABOi LT in our centre. Methods: This retrospective observational study was conducted on patients who underwent CP included in the desensitization protocol for ABOi LDLT. CP/conventional TPE was performed (daily/alternate day with daily estimation of AT) until a target titre of <= 8 was achieved. Results: During the study period, 4 patients (mean age 46.7 years; 100% males) underwent desensitization for ABOi LDLT with baseline AT (combined IgM and IgG) ranging from 64 to 512. A total of 15 CP sessions (range 2 - 6) were performed with a median of 3.5 sessions/patient. Desensitization rate was 100%. Only 1 patient underwent conventional TPE in the post-transplant due to rise in AT level to 64 (post-operative day 8). Average post-operative length of stay was 49 days (range 30 - 105). None of the patients experienced any episode of rejection (repeat liver biopsy). On follow up (1 year), 2 patients were alive and doing well, while other 2 patients succumbed during their hospital stay due to sepsis. Conclusion: In our limited experience, the use of CP was safe and effective desensitization strategy for patients undergoing ABOi LDLT.
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页码:442 / 446
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Keio Univ, Sch Med, Dept Surg, Tokyo 160, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Kato, Yukinari
Kaneko, Mika Kato
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Keio Univ, Sch Med, Dept Surg, Tokyo 160, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Kaneko, Mika Kato
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Ogasawara, Satoshi
Shimazu, Motohide
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Tokyo Med Univ, Hachioji Med Ctr, Dept Digest Surg, Tokyo, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Shimazu, Motohide
Tanabe, Minoru
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Natl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Tanabe, Minoru
Kawachi, Shigeyuki
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Natl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
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Obara, Hideki
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Natl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Obara, Hideki
Shinoda, Masahiro
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Natl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Shinoda, Masahiro
Kitagawa, Yuko
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Kitagawa, Yuko
Narimatsu, Hisashi
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Keio Univ, Sch Med, Dept Surg, Tokyo 160, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Narimatsu, Hisashi
Kitajima, Masaki
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Int Univ Hlth &Welfare, Mita Hosp, Dept Surg, Tokyo, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
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Keio Univ, Sch Med, Dept Surg, Tokyo 160, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Kato, Yukinari
Kaneko, Mika Kato
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Keio Univ, Sch Med, Dept Surg, Tokyo 160, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Kaneko, Mika Kato
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Ogasawara, Satoshi
Shimazu, Motohide
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Tokyo Med Univ, Hachioji Med Ctr, Dept Digest Surg, Tokyo, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Shimazu, Motohide
Tanabe, Minoru
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Natl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Tanabe, Minoru
Kawachi, Shigeyuki
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Natl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Kawachi, Shigeyuki
Obara, Hideki
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Natl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Obara, Hideki
Shinoda, Masahiro
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Natl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Shinoda, Masahiro
Kitagawa, Yuko
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Natl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Kitagawa, Yuko
Narimatsu, Hisashi
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Keio Univ, Sch Med, Dept Surg, Tokyo 160, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan
Narimatsu, Hisashi
Kitajima, Masaki
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Int Univ Hlth &Welfare, Mita Hosp, Dept Surg, Tokyo, JapanNatl Inst Adv Ind Sci & Technol, Res Ctr Med Glycosci, Tsukuba, Ibaraki 3058568, Japan