4)ABO不適合腎移植とアフェレシス(〈シンポジウム〉各科領域におけるアフェレシス療法)

概要

論文の詳細を見る
Apheresis is an essential modality for the success of ABO incompatible kidney transplantation. In Japan, plasma exchange and double filtration plasma pheresis are standard therapeutic methods in ABO incompatible kidney transplantation. These methods are performed two or three times for prior to kidney transplantation, attempting to reduce the titers of circulating anti-A antibody or anti-B antibody of recipients. It is said that the titers less than 8 or 16 folds are critical levels to prevent renal graft from the acute rejection derived from ABO incompatibility. In ABO incompatible kidney transplantation, blood type A or B antigens expressed on the surface of endothelium of renal graft combine with circulating anti-A antibody or anti-B antibody in recipient's blood. Immune complexes formed on endothelial surface result in initiators of severe acute rejection presenting intravascular coagulation in renal graft. As compared with other countries, Japanese renal transplantation depends on the living transplantation between family members. When we respect the willingness of donation, therapeutic apheresis in ABO imcompatible kidney transplantation becomes an important remedy to expand the medical adaptation of living transplantation.
新潟大学の論文