Therapeutic apheresis in kidney transplantation: Emerging trends

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Main Authors: Chimezie Godswill Okwuonu, Monarch Shah, Iram Rafique, Abdallah Saleh Abdelrazeq, Jeanne Kamal, Swati Rao, Rasheed Abiodun Balogun
Format: Artículo Open Access
Published: Wiley 2024
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author Chimezie Godswill Okwuonu
Monarch Shah
Iram Rafique
Abdallah Saleh Abdelrazeq
Jeanne Kamal
Swati Rao
Rasheed Abiodun Balogun
author_facet Chimezie Godswill Okwuonu
Monarch Shah
Iram Rafique
Abdallah Saleh Abdelrazeq
Jeanne Kamal
Swati Rao
Rasheed Abiodun Balogun
Chimezie Godswill Okwuonu
Monarch Shah
Iram Rafique
Abdallah Saleh Abdelrazeq
Jeanne Kamal
Swati Rao
Rasheed Abiodun Balogun
collection Wiley Open Access
contents Therapeutic apheresis in kidney transplantation: Emerging trends Chimezie Godswill Okwuonu Monarch Shah Iram Rafique Abdallah Saleh Abdelrazeq Jeanne Kamal Swati Rao Rasheed Abiodun Balogun Journal of Clinical Apheresis AbstractIntroductionThe use of therapeutic apheresis (TA) either as stand‐alone or adjunctive treatment in kidney transplantation has increased over the years to become a leading indication. This study shows recent trends in indications for TA related to kidney transplantation, adverse events, and patient outcome in this cohort.MethodsThis is a retrospective cohort review of adults who received TA for kidney transplant‐related indications from January 1, 2017, to December 31, 2022, at the University of Virginia Medical Centre, Charlottesville, VA, USA. Data extracted include basic demographics, indication for apheresis, number of procedures, procedure characteristics, procedure‐related adverse events (complications), and serum ionized calcium and serum creatinine. Data were analyzed using statistical package for social sciences (SPSS 2022 IBM Inc).ResultsData from a total of 131 patients who received 860 TA procedures were analyzed. Indications for TA were antibody‐mediated rejection (65.5%), recurrent focal segmental glomerulosclerosis (15%), thrombotic microangiopathy (5%), desensitization for ABO incompatibility (4.5%) and for HLA‐incompatibility (4.5%), and recurrent IgA nephropathy (1%). Some adverse events were encountered in 16.7% of the procedures and include hypocalcemia (7%), vascular access malfunction (0.7%), hypotension (1.2%), arrhythmia (0.6%), and depletion coagulopathy (0.6%). The overall case mortality rate was 8.4% over the 6‐year period. There was one death recorded on machine during TA resulting in a procedure‐mortality rate of 0.12%.ConclusionAntibody‐mediated rejection was the most common indication for TA related to kidney transplantation. Adverse events were minor and patient survival over the time was within usual limits. 10.1002/jca.22119 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1002/jca.22119
format Artículo Open Access
id wiley_oa_10_1002_jca_22119
institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by/4.0/
publishDate 2024
publisher Wiley
record_format wiley_oa
spellingShingle Therapeutic apheresis in kidney transplantation: Emerging trends
Chimezie Godswill Okwuonu
Monarch Shah
Iram Rafique
Abdallah Saleh Abdelrazeq
Jeanne Kamal
Swati Rao
Rasheed Abiodun Balogun
Journal of Clinical Apheresis
Therapeutic apheresis in kidney transplantation: Emerging trends Chimezie Godswill Okwuonu Monarch Shah Iram Rafique Abdallah Saleh Abdelrazeq Jeanne Kamal Swati Rao Rasheed Abiodun Balogun Journal of Clinical Apheresis AbstractIntroductionThe use of therapeutic apheresis (TA) either as stand‐alone or adjunctive treatment in kidney transplantation has increased over the years to become a leading indication. This study shows recent trends in indications for TA related to kidney transplantation, adverse events, and patient outcome in this cohort.MethodsThis is a retrospective cohort review of adults who received TA for kidney transplant‐related indications from January 1, 2017, to December 31, 2022, at the University of Virginia Medical Centre, Charlottesville, VA, USA. Data extracted include basic demographics, indication for apheresis, number of procedures, procedure characteristics, procedure‐related adverse events (complications), and serum ionized calcium and serum creatinine. Data were analyzed using statistical package for social sciences (SPSS 2022 IBM Inc).ResultsData from a total of 131 patients who received 860 TA procedures were analyzed. Indications for TA were antibody‐mediated rejection (65.5%), recurrent focal segmental glomerulosclerosis (15%), thrombotic microangiopathy (5%), desensitization for ABO incompatibility (4.5%) and for HLA‐incompatibility (4.5%), and recurrent IgA nephropathy (1%). Some adverse events were encountered in 16.7% of the procedures and include hypocalcemia (7%), vascular access malfunction (0.7%), hypotension (1.2%), arrhythmia (0.6%), and depletion coagulopathy (0.6%). The overall case mortality rate was 8.4% over the 6‐year period. There was one death recorded on machine during TA resulting in a procedure‐mortality rate of 0.12%.ConclusionAntibody‐mediated rejection was the most common indication for TA related to kidney transplantation. Adverse events were minor and patient survival over the time was within usual limits. 10.1002/jca.22119 http://creativecommons.org/licenses/by/4.0/
title Therapeutic apheresis in kidney transplantation: Emerging trends
topic Journal of Clinical Apheresis
url https://onlinelibrary.wiley.com/doi/10.1002/jca.22119