Affiliation:
1. Department of Nephrology Nagoya University Hospital Nagoya Aichi Japan
2. Department of Nephrology Nagoya University Graduate School of Medicine Nagoya Aichi Japan
3. Department of Urology Nagoya University Graduate School of Medicine Nagoya Aichi Japan
Abstract
AbstractIntroductionSimple plasma exchange (PE) with fresh‐frozen plasma replacement allows antibody removal for ABO‐incompatible living donor kidney transplantation, but is associated with a high incidence of allergic reactions. We developed, implemented, and evaluated a protocol for safe preoperative PE.MethodsThe protocol comprised pretreatment (125 mg methylprednisolone infusion, 400 mg acetaminophen and 30 mg diphenhydramine orally) with a replacement fluid rate < 20 mL/min. Allergic reaction incidence was investigated in controls who underwent ABO‐incompatible living donor kidney transplantation between 2016 and March 2020 (group C) and patients who underwent the protocol and procedure between April 2020 and February 2023 (group N).ResultsTen (group C) and 19 (group N) patients performed 11 and 30 sessions of PE, respectively. Allergic reactions occurred in 81.8% and 36.7% (p = 0.014), respectively, with an odds ratio of the protocol was 0.056 (95% CI 0.0059–0.5380, P = 0.013).ConclusionOur protocol resulted in a significantly lower incidence of allergic reactions.