World Journal of Nephrology and Urology, ISSN 1927-1239 print, 1927-1247 online, Open Access
Article copyright, the authors; Journal compilation copyright, World J Nephrol Urol and Elmer Press Inc
Journal website https://wjnu.elmerpub.com

Original Article

Volume 14, Number 2, November 2025, pages 35-43

Successful Usage of Extracorporeal Plasma Perfusion Adsorption Devices Columns for Desensitization Through Immunoadsorption in End-Stage Renal Disease Patients for ABO-Incompatible Kidney Transplant

Figures

↓  Figure 1. SECORIM® immunoadsorption column setup.
Figure 1.
↓  Figure 2. Pre- and post-desensitization IgG isoagglutinin titers across patients.
Figure 2.
↓  Figure 3. Pre- and post-desensitization IgM isoagglutinin titers across patients.
Figure 3.
↓  Figure 4. Last serum creatinine levels at discharge across patients.
Figure 4.
↓  Figure 5. Last tacrolimus levels at discharge across patients.
Figure 5.

Tables

↓  Table 1. Overview of Immunological Strategy in ABOiKT
 
Step Description
ABOiKT: ABO-incompatible kidney transplantation; HLA: human leukocyte antigen; IA: immunoadsorption.
Donor-recipient mismatch ABO blood group incompatibility
Pre-transplant evaluation Blood group typing, HLA matching, antibody titers (IgG, IgM)
Desensitization initiation Rituximab infusion, followed by IA or plasmapheresis
Surgical procedure End-to-side vascular anastomosis under general anesthesia
Post-operative immunosuppression Tacrolimus, mycophenolate, steroids, and monitoring of tac/titers/creatinine

 

↓  Table 2. Demographic and Clinical Parameters at Discharge
 
Patient number Transplant date Age (years) Gender CKD stage Donor relationship Recipient blood group Donor blood group Transplant
CKD: chronic kidney disease.
1 12/11/2022 46 F Stage 5 Husband B+ A+ Successful
2 13/01/2023 41 M Stage 5 Father O+ A+ Successful
3 03/07/2024 51 M Stage 5 Wife O+ B+ Successful
4 14/03/2024 45 F Stage 5 Mother B+ A+ Successful
5 1/10/2024 42 F Stage 5 Sister B+ A+ Successful
6 20/10/2021 45 F Stage 5 Mother A+ AB+ Successful
7 01/10/2024 30 M Stage 5 Wife O+ B+ Successful
8 02/05/2024 33 M Stage 5 Brother O+ A+ Successful
9 12/10/2021 41 M Stage 5 Sister B+ AB+ Successful
10 21/03/2024 32 M Stage 5 Brother B+ AB+ Successful
11 16/092022 33 M Stage 5 Wife A+ B+ Successful
12 29/04/2022 28 M Stage 5 Mother O+ A+ Successful
13 20/10/2021 44 F Stage 5 Mother A+ AB+ Successful
14 7/09/2021 40 M Stage 5 Mother B+ AB+ Successful
15 19/02/2020 35 M Stage 5 Maternal uncle B+ A+ Successful
16 13/04/2022 33 F Stage 5 Father A+ AB+ Successful
17 7/02/2022 23 M Stage 5 Father O+ B+ Successful
18 23/09/2021 39 M Stage 5 Wife O+ AB+ Successful
19 16/07/2021 61 M Stage 5 Wife O+ B+ Successful
20 31/01/2020 48 M Stage 5 Wife O+ B+ Successful
21 13/01/2023 44 M Stage 5 Father O+ A+ Successful

 

↓  Table 3. Desensitization Protocol and Isoagglutinin Titers
 
Patient number Immunoadsorption sessions Column used Pre-IgG titer Pre-IgM titer Post-IgG titer Post-IgM titer
NA: data not available.
1 2 A 1:64 1:8 Nil NA
2 2 A 1:128 1:32 1:2 NA
3 2 B 1:256 1:128 1:4 1:2
4 1 A 1:128 1:64 1:4 1:2
5 2 A 1:512 1:512 1:8 NA
6 1 B 1:32 1:4 1:2 Nil
7 2 B 1:1,024 1:512 1:4 1:4
8 2 A 1:512 1:512 1:8 1:2
9 1 A 1:32 Nil 1:2 NA
10 2 A 1:64 1:32 1:4 1:4
11 3 B 1:64 1:64 1:4 1:2
12 2 A 1:256 1:256 1:4 1:2
13 2 B 1:512 1:256 1:2 1:4
14 3 A 1:1,024 1:512 1:8 1:4
15 1 A 1:64 1:32 1:1 Nil
16 1 B 1:128 NA 1:2 NA
17 2 B 1:128 1:64 1:2 1:2
18 2 AB - - - -
B 1:128 NA 1:2 NA
A 1:64 NA 1:4 NA
19 2 B 1:128 1:128 1:2 1:1
20 2 B 1:128 1:64 1:2 1:2
21 2 A 1:128 1:256 1:2 1:2

 

↓  Table 4. Post-Transplant Graft Function Indicators: Creatinine and Tacrolimus Levels at Discharge
 
Patient number Days from admission to discharge Last creatinine (mg/dL) Tacrolimus (ng/mL)
1 12 0.77 8.2
2 11 1.09 24.9
3 9 0.98 7.30
4 9 0.6 16.75
5 10 0.93 13.91
6 8 0.71 9.54
7 10 1.44 6.19
8 9 0.74 7.12
9 9 1.7 6.4
10 9 0.85 6.6
11 11 1.44 9.67
12 21 1.89 8.10
13 6 1.2 10.6
14 10 0.97 22
15 9 1.26 22
16 10 0.77 8.1
17 9 1.49 14.2
18 6 1.59 11.8
19 11 2.61 5.64
20 10 1.19 9.2
21 11 1.09 24.9