Until recently, a transplant patient could only receive an organ from someone with a compatible blood type. An organ from someone with an incompatible blood type would be perceived as foreign and vulnerable to attack by the recipient's natural antibodies. Now, through a process called plasmapheresis, a recipient can receive a kidney from a donor of a different blood type. This procedure is currently being provided at a growing number of transplant centers.
What is plasmapheresis?
Plasmapheresis is a process that filters the blood and removes harmful antibodies. It is a procedure done similarly to dialysis; however, it specifically removes antibodies from the plasma portion of the blood. Antibodies are part of the body’s natural defense system which help destroy things that are not a natural part of our own bodies, like germs or bacteria. Antibodies against blood proteins can lead to rejection after a blood-type incompatible transplant. In severe cases, this could cause the kidney transplant to fail. Plasmapheresis before transplant removes antibodies against the donor blood-type from the recipient, so they can’t attack and damage the donated kidney.
Depending on the antibody levels and the transplant center protocols, a medicine to keep more antibodies from forming may also be administered intravenously. In rare cases, the patient's spleen is removed using minimally invasive surgical technique to keep antibody levels low.
After the transplant, the patient may require additional plasmapheresis treatments before discharge from the hospital. He or she will then take the similar immunosuppression medications as patients receiving a blood type compatible kidney. At some centers, a biopsy may be done soon after transplant to ensure antibodies are not causing rejection of the transplanted kidney.
Are there other reasons my healthcare provider might recommend plasmapheresis?
Patients with rare causes of kidney disease such as Wegner’s granulomatosis or Goodpasture syndrome may undergo plasmapheresis to treat their disease. Additionally, plasmapheresis is done after kidney transplant to treat cases of antibody-mediated rejection.
