Abstract:
:The supply of deceased donor kidneys is inadequate to meet demand. To expand the pool of potential donors, ABO-incompatible transplants from living donors have been performed. We present the Mayo Clinic experience with such transplants. Enrollment was open to patients when the only available potential living kidney donor was ABO-incompatible. Conditioning consisted of plasma exchanges followed by intravenous immunoglobulin. Splenectomy was performed at the time of transplant surgery. Post-transplant immunosuppression consisted of anti-T lymphocyte antibody, tacrolimus, mycophenolate mofetil, and prednisone. Isoagglutinin titers and scores were determined before and after each plasma exchange. Transplant outcomes were determined. Twenty-six ABO-incompatible transplants were performed. No hyperacute rejection occurred. Mean patient follow-up was 400 days. Patient and graft survivals at last follow-up were 92 and 85%, respectively. Antibody-mediated rejection occurred in 46% and was apparently reversed in 83% by plasma exchange and increased immunosuppression. The initial plasma exchange reduced immediate spin and AHG hemagglutination reactivity scores by 53.5 and 34.6%, respectively. Over the course of the pretransplant plasma exchanges, the immediate spin and AHG hemagglutination reactivity scores decreased by 96.4 and 68.5%, respectively. At 3 and 12 months, the immediate spin and AHG hemagglutinin reactivity scores and titers were less than those at baseline but greater than or equal to those on the day of transplantation. Despite an increase in scores and titers, antibody-mediated rejection was not present. Pre-transplant plasma exchange conditioning combined with other immunosuppressives can be used to prepare patients for ABO-incompatible kidney transplantation from living donors, but antibody-mediated rejection post-transplant is a common occurrence and allograft survival may be reduced. Controlled clinical trials are needed to identify the optimum conditioning for ABO-incompatible renal transplants.
journal_name
J Clin Apherjournal_title
Journal of clinical apheresisauthors
Winters JL,Gloor JM,Pineda AA,Stegall MD,Moore SBdoi
10.1002/jca.20002subject
Has Abstractpub_date
2004-01-01 00:00:00pages
79-85issue
2eissn
0733-2459issn
1098-1101journal_volume
19pub_type
杂志文章abstract:BACKGROUND:Autologous stem cell transplantation (auto-SCT) is a treatment approach in non-Hodgkin lymphoma (NHL) patients. The options for mobilization of CD34+ cells to support high-dose therapy are granulocyte-colony stimulating factors (G-CSFs) alone or after chemotherapy. Limited data exist on the efficacy of lipeg...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21785
更新日期:2020-08-01 00:00:00
abstract::The process of publishing original work in a peer review journal is not complete at the point where the manuscript is first submitted. The journal editors will submit the manuscript to peer review whereby outside experts are asked to vet the manuscript for scientific merit, originality and quality. Reviewers' comments...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.21822
更新日期:2020-08-07 00:00:00
abstract::The issues of providing quality blood products and maintaining donor safety are primary aims of blood transfusion services. A comprehensive quality system should be in place to fulfill these aims, which can be attained through strict adherence to the established standard operating procedures (SOPs). The Drugs and Cosm...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20056
更新日期:2005-07-01 00:00:00
abstract::Idiopathic inflammatory demyelinating diseases (IIDDs) of the central nervous system, of which multiple sclerosis is the prototype, represent a family of monophasic, recurrent or progressive diseases with overlapping clinical and pathological manifestations. While most patients recover spontaneously or following a bri...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/(sici)1098-1101(1999)14:3<144::aid-jca7>3.
更新日期:1999-01-01 00:00:00
abstract::The recent introduction of low-density lipoprotein (LDL)/very low-density lipoprotein (VLDL) selective-removal systems offers an alternative to plasma exchange (PE). For the last 10 years, we have treated a male homozygous hypercholesterolemia type IIA patient with PE using 5% normal serum albumin (NSA) replacement, P...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920070206
更新日期:1992-01-01 00:00:00
abstract::The aim of this study was to analyze the impact of various donor and machine parameters on PLT yield in 127 PLT apheresis procedures, to optimize PLT yield achieving clinical and economic advantages. One hundred and twenty-seven apheresis procedures were analyzed. Age, gender, volume processed, Hb, and PLT precounts w...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20116
更新日期:2007-02-01 00:00:00
abstract::We have reviewed our initial experience with a program of concurrent collection of plasma (CCP) during plateletpheresis, which was instituted to increase the number of units of fresh frozen plasma produced by our hospital-based donor service. Sixty percent of eligible donors (1,006 of 1,682) participated in CCP, and 2...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920090207
更新日期:1994-01-01 00:00:00
abstract::A "snapshot" survey of physician coverage for evaluation and supervision of therapeutic apheresis procedures shows significant variation in current clinical practice between 39 blood center-and 41 non-blood center-based programs. Whereas 56% of blood center-based programs usually require physician's "in person" evalua...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920100405
更新日期:1995-01-01 00:00:00
abstract::We describe the case of a 24 year old male with severe fistulating Crohn's disease who failed mutliple modalities of medical and surgical therapy. We present objective and subjective evidence of disease remission after induction and maintenance treatment with leukocyte apheresis. This is the first described case of su...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21308
更新日期:2014-06-01 00:00:00
abstract::We have recognized marked effectiveness for intermittent claudication with low-density lipoprotein (LDL) apheresis in two cases of arteriosclerosis obliterans (ASO). The Case 1 was a 73-year-old man with intermittent claudication of both lower extremities (Fontaine class II), digital subtraction angiography (DSA) reve...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20138
更新日期:2007-01-01 00:00:00
abstract::Extracorporeal photopheresis (ECP) in young pediatric patients has a risk for procedural hypotension and anemia due to extracorporeal fluid shifts. A standard mitigation policy in these patients is to prime the device with packed red blood cells (RBC) or whole blood. We now report multiple episodes of hemolysis while ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21740
更新日期:2019-12-01 00:00:00
abstract::One of the most serious problems in applying leukapheresis to human infants is the large extracorporeal blood volume (ECV), resulting in substantial loss of platelets and red blood cells (RBCs). In this study, we developed a safe and effective modified procedure to collect peripheral blood stem cells (PBSCs) from rhes...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.10043
更新日期:2003-01-01 00:00:00
abstract::This study chronicles leukocyte- and erythrocyte-depleted platelet concentrate collection by a dual stage channel in which three variables: 1) donor peripheral blood platelet concentration, 2) total blood processed, and 3) collection volume were statistically correlated with platelet yield as determined by a multiple ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920020304
更新日期:1985-01-01 00:00:00
abstract::When harvesting peripheral progenitor cells (PPC) in children, the special situation of their circulatory system has to be taken into account. Therefore, extracorporeal blood volume and product volume should be small to avoid side effects. Nine children (age 2-14 years, weight 12.8-58.5 kg) with malignancies underwent...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.10050
更新日期:2003-01-01 00:00:00
abstract::Dysmetabolic iron overload syndrome is a rare event causing hepatic impairment with serious long-term side effects. Here, we describe a case of metabolic syndrome-related hepatic iron overload that showed a rapid, effective, and safe response to erythrocytapheresis. J. Clin. Apheresis 31:443-447, 2016. © 2015 Wiley Pe...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21434
更新日期:2016-10-01 00:00:00
abstract::Targeted extracorporeal granulocyte and monocyte apheresis (GMA) has produced clinical efficacy together with down modulation of specific inflammatory cytokines in patients with ulcerative colitis (UC). This study was to investigate if preoperative GMA produces immunological effect on dysregulated immune activity afte...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,随机对照试验
doi:10.1002/jca.21299
更新日期:2014-04-01 00:00:00
abstract::Sickle cell disease (SCD) patients are prone to develop complications that include stroke, acute chest syndrome, and other crises. Some of these complications require chronic transfusion therapy or red cell exchange (RCE), either for therapeutic or prophylactic reasons. Due to a discrepancy of red cell antigens betwee...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.20112
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Securing adequate vascular access is essential for a successful apheresis procedure. In most, peripheral access is preferred but it is not always technically possible. Ultrasound-Guided Peripheral Vascular Access (USG-PIVA) is a well-documented technique in the setting of Emergency departments. However, limi...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21440
更新日期:2016-12-01 00:00:00
abstract:INTRODUCTION:ABO- or HLA-incompatible kidney transplantation is possible thanks to pretransplant antibody-depletion achieved by extracorporeal-treatment modalities. These methods induce depletion of some plasma proteins and may also impact on proteins involved in hemostasis. METHODS:To determine the impact of one sess...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21825
更新日期:2020-08-17 00:00:00
abstract::Folinic acid (FA) has been reported to expand the pool of peripheral blood stem cells (PBSC) after chemotherapy. We evaluated the efficacy of FA for harvesting PBSC following cytotoxic chemotherapy in 4 patients with acute leukemia. After achieving a complete remission (CR), 3 courses of chemotherapy for a consolidati...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920070410
更新日期:1992-01-01 00:00:00
abstract::The blood flow property is one of the factors determining blood perfusion and oxygen supply. The viscosity of the blood is primarily related to the hematocrit, but also to the amount of fibrinogen and other macromolecules present in the blood. Patients with ischemic heart disease have shown a rapid and safe improvemen...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/(sici)1098-1101(1997)12:4<183::aid-jca5>3.
更新日期:1997-01-01 00:00:00
abstract::The influence of 6 weeks of cyclosporin A (CYA), followed by a further 6 weeks of this agent in combination with plasma exchange (PE), was defined on panel reactivity and titre of preformed cytotoxic antibodies in stable patients on haemodialysis awaiting renal transplantation. Nine individuals with antibodies to 30% ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920060107
更新日期:1991-01-01 00:00:00
abstract::Lipid-apheresis (LA) is thought to improve microcirculation. However, limited data are available on the effects on peripheral microcirculation. We investigated upper limb microcirculation of 22 patients undergoing regular LA on a weekly basis before and after LA. Using standardized semiquantitative scales, we analyzed...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20285
更新日期:2011-01-01 00:00:00
abstract:PURPOSE:Wilson's disease is a rare autosomal recessive genetic disorder that results in accumulation of copper in the liver, brain, cornea and kidney. Therapeutic plasma exchange (TPE) has been used to remove copper and provide a bridge to liver transplantation. We report here the collective experiences through the ASF...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,多中心研究
doi:10.1002/jca.21396
更新日期:2016-02-01 00:00:00
abstract::Complement-derived anaphylatoxin may be one of the causes of vascular injury and an indicator of activity in systemic lupus erythematosus (SLE). The present study examines the effectiveness of dextran sulfate (DS) column immunoadsorption treatment to remove anaphylatoxins (C3a, C4a, and C5a) from the blood of patients...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/(sici)1098-1101(1998)13:3<108::aid-jca3>3.
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Therapeutic plasma exchange (TPE) may remove medications from the patient's plasma. Data is limited on the effect of TPE on unfractionated heparin (UFH). STUDY DESIGN AND METHODS:A retrospective review was performed of patients receiving TPE and continuous IV infusion UFH from 1/1/2008 to 6/30/2010. TPE wit...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21441
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Transfusion of D+ red blood cells (RBCs) to D- recipients can be accidental or necessary due to D- RBC shortage. Alloimmunization can complicate future transfusions; implications for women of childbearing age are compounded by possible hemolytic disease of the fetus and newborn. Rh immunoprophylaxis is effec...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20225
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Autoimmune disorders and neurodegenerative disorders take a physical and emotional toll on patients that undergo therapeutic plasma exchange (TPE) treatments. Previous literature has shown that these patients may feel a greater sense of self-burden. Motivational Interviewing (MI) is a technique used in vario...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21645
更新日期:2018-10-01 00:00:00
abstract::Mobilized stem cells in the peripheral blood (PB) must be efficiently harvested at the appropriate time before autologous PB stem cell (PBSC) transplantation. Enumeration of CD34+ cells in the PB before apheresis predicts the number of PBSCs that can be collected, but the cytometric techniques used are complex and exp...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20275
更新日期:2011-01-01 00:00:00
abstract::Management of aTTP in patients who refuse or are intolerant to plasma remains challenging, but new drugs can be implemented with success. A 39-year-old woman presented to the Emergency department for bruises at the upper and lower limbs together with worsening anemia and thrombocytopenia; PLASMIC score was seven, indi...
journal_title:Journal of clinical apheresis
pub_type:
doi:10.1002/jca.21877
更新日期:2021-01-18 00:00:00