Open AccessTherapeutic apheresis in kidney transplantation: An updated review
Author(s) -
Maurizio Salvadori,
Aris Tsalouchos
Publication year - 2019
Publication title -
world journal of transplantation
Language(s) - Uncategorized
Resource type - Journals
ISSN - 2220-3230
DOI - 10.5500/wjt.v9.i6.103
Subject(s) - medicine , apheresis , therapeutic approach , kidney transplantation , transplantation , therapeutic effect , abo blood group system , intensive care medicine , extracorporeal , plasmapheresis , immunology , antibody , surgery , disease , platelet
Therapeutic apheresis is a cornerstone of therapy for several conditions in transplantation medicine and is available in different technical variants. In the setting of kidney transplantation, immunological barriers such as ABO blood group incompatibility and preformed donor-specific antibodies can complicate the outcome of deceased- or living- donor transplantation. Postoperatively, additional problems such as antibody-mediated rejection and a recurrence of primary focal segmental glomerulosclerosis can limit therapeutic success and decrease graft survival. Therapeutic apheresis techniques find application in these issues by separating and selectively removing exchanging or modifying pathogenic material from the patient by an extracorporeal aphaeresis system. The purpose of this review is to describe the available techniques of therapeutic aphaeresis with their specific advantages and disadvantages and examine the evidence supporting the application of therapeutic aphaeresis as an adjunctive therapeutic option to immunosuppressive agents in protocols before and after kidney transplantation.