FP827COMPARISON OF ANTIGEN SPECIFIC VERSUS UNSPECIFIC IMMUNOADSORPTION IN ABO INCOMPATIBLE RENAL TRANSPLANTATION

Abstract

Introduction and Aims: ABO‐incompatible (ABOi) renal transplantation (RTx) from living donors is an established procedure to expand the donor pool for patients with end stage renal disease. Immunoadsorption (IA) is a standard procedure for the removal of preformed antibodies against the allograft. In this study, we compare antigen‐specific versus ‐unspecific IA in ABOi RTx. Methods: 10 patients underwent antigen‐specific IA (Glycosorb group) and 13 patients antigen‐unspecific IA (Immunosorba group). The efficiencies of both procedures, the need of additional plasmaphereses (PPh) as well as the outcome of the transplant and the patients were compared between the groups. Results: The patients in both groups needed a similar number of IA and additional PPh before and after ABOi RTx. Although the IgG levels were reduced in similar amounts by both procedures, the reduction of the IgM level had been more effective in the Glycosorb group. 12 months after ABOi RTx the renal function of the patients of the Glycosorb and Immunosorba group was nearly identical and the allograft survival rates were 90.0% and 92.3%, respectively. The complication rates were similar in both groups. The costs for the antigen‐unspecific Immunosorba columns were considerably lower. Conclusions: The renal outcome and complication rates were comparable between the antigen‐specific and antigen‐unspecific IA group. While the Immunosorba‐based IA was more cost effective than Glycosorb, the Glycosorb‐based IA was more time‐saving. However, since dialysis and IA might be performed in combination or the reuse of Glycosorb columns might be commonly established, the advantages and disadvantages might change in the future.