Splenic Radiation and Double-Filtration Plasmapheresis in Crossmatch-Positive Live Renal Transplantation

Combination treatment of low dose Anti-Thymocyte Globulin (ATG), Rituximab and high dose Sirolimus as induction agents in immune-conditioned recipients

“…A few studies have indicated that splenic radiation at lower doses is more useful or more effective than high doses [6], which can in fact be detrimental versus time. Our own reports have shown that low dose radiation is safe and devoid of surgical risk [2].…”

“…Double Filtration Plasmapheresis and splenic radiation has been described as a useful immune conditioning regimen in high risk individuals [2] but its limited use as an additional therapy in low risk group showed a better graft function in the initial post-operative period compared to the high risk group, and this helped us to reduce the dose of steroids in GpI and also use CNI at lower doses. Whether these two procedures will be of use in long term graft function is questionable because the renal function in both groups was comparable at the end of six months.…”

“…Reduction of alloreactive cells has the potential to avoid graft destruction [1]. Pretransplant immune conditioning, which includes various regimens such as plasmapheresis, splenectomy, and whole body irradiation, may further prevent a destructive immune response to the donor transplanted organ [2]. Apart from International Immunopharmacology 6 (2006) 1973 -1976 www.elsevier.com/locate/intimp this, maintenance of pharmacologic immunosuppression has been necessary to prevent rejection.…”

A Controlled Study of Double Filtration Plasmapheresis in the Treatment of Active Rheumatoid Arthritis

“…[6][7][8] DFPP, which we propose as a treatment for refractory RA, selectively removes high molecular-weight substances such as immunoglobulins, immune complexes, and lipoproteins 11 and has several advantages over PE. 8 DFPP has been reported to be helpful for renal transplant recipients, [12][13][14] Guillain-Barre syndrome, [15][16][17] myasthenia-gravis, 18,19 and systemic lupus erythematosus. 20 In 1 study of plasmapheresis for myasthenia gravis, PE and DFPP showed comparable abilities to remove acetylcholine receptor antibodies.…”