The Use of Immune Sorbtion at AB0 - Incompatible Transplantation of Organs from Live Relative Donor

The article indentifies the experience of immunoabsorption at AB0-incompatible organ transplantation from live donor. The aim of the paper is to describe the use of immunoabsorption at AB0-incompatible organ transplantation from live donor in the Department of extracorporal methods of treatment of State Institution “Heart Institute of the Ministry of Health of Ukraine”. Materials and methods. Patient who is 38 years old was hospitalized to the department of kidney transplantation with terminal chronic renal failure based on chronic glomerulonephritis. Patient complained of general weakness, high arterial pressure, anuria. General condition of the patient is in moderate severity, skin and superficial mucous linings are pale, skin tightness is decreased, arterial pressure is 180/90 mm, heart contractions rate is 100 per minute. Primary function of homocellular organ was satisfactory and was accompanied by high diuresis, and decrease level of creatinine to 133,6 mcM/l to the end of the first postoperative week. The control of the reaction of immune system of recipient was carried out weekly during the first postoperative month and after that once in month according to the level of anti-А/В of antibodies, the number of B cells and indices of T-cell crossmatching. Results. This method involves the removal of plasma of anti-A or anti-B antibodies (and isoagglutinins α and β) before organ transplantation from AB0-incompatible live donor, and differs in the use of specific affine sorbent with immobilized glycoconjugates A, for the removal of anti-A antibodies (isoagglutinins α) and glycoconjugates B, for removal of the anti-B antibodies (isoagglutinins β). They are specifically sorbing on the surface of the column, and do not remove other blood components. Immunoabsorption was carried out to the development of the target titer of anti-A / B antibodies 1: 4. Conclusions. Based on our results, it was considered that the proposed method of plasma antibodies of anti-A and anti-B (isoagglutinins α and β) of removal before organ transplantation from AB0-incompatible donor is a promising direction of transplantology, which opens the real way to increase pool of live donors and can assist in solving the problem of acute deficiency of deceased donor organ. Prospects for further investigations. Further investigations will be directed into studying new extracorporal methods which can assist in removing antibodies (anti-A or anti-B) from the plasma and overpassing the barrier of group incompatibility during surgeries of organ transplantation of АВ0- incompatible live donor during the treatment of patients with terminal stage of insufficiency of the function of the organ.