Background/aims: Antibody-mediated rejection (AMR) is related to circulating donor-specific anti-human leukocyte antigen alloantibodies (DSAs). DSAs can be removed by apheresis, for example, double-filtration plasmapheresis (DFPP). However, DFPP removes some clotting factors (fibrinogen and factor XIII [FXIII]).
Methods: This was a prospective trial including 6 DSA-mediated AMR kidney transplant recipients. Patients received 2 cycles of 3-4 consecutive DFPP sessions followed by 1 injection of rituximab (break of 4-5 days between the 2 cycles). We monitored fibrinogen and FXIII levels before and after each session of DFPP.
Results: Overall, fibrinogen and FXIII levels were significantly decreased after each session, and were significantly reduced between the very first and very last sessions. In addition, we established a model that predicted fibrinogen and FXIII values after each session and after 2 cycles.
Conclusion: We established a model in order to predict fibrinogen and FXIII depletion after DFPP sessions; it may help clinicians supplement fibrinogen and/or FXIII when appropriate.
Keywords: Chronic antibody-mediated rejection; Decrease; Double-filtration plasmapheresis; Factor XIII; Fibrinogen.
© 2018 S. Karger AG, Basel.