Effect of Apheresis for ABO and HLA Desensitization on Anti-Measles Antibody Titers in Renal Transplantation

الملخص EN

Desensitization strategies for ABO-incompatible renal transplants with plasma exchange (PE) or specific immunoadsorption (IA) decrease immunoglobulin levels.

After recent measles outbreak and decreasing vaccination rates, we studied the impact of apheresis on anti-measles antibodies.

Anti-measles antibodies were measured before desensitization, before transplantation and during followup in 12 patients with ABO incompatibility (2x PE only, 8x IA only, and 2x IA and PE) and 3 patients with donor-specific HLA antibodies (all PE).

Patients received rituximab, IVIG, and standard immunosuppressive therapy.

All patients had detectable anti-measles antibodies before desensitization (mean 3238 mU/l, range 560–8100).

After 3–6 PE sessions, titers decreased significantly to 1710 mU/l (P<0.05), in one patient to nondetectable values, while IA only maintained protective titers.

After a median followup of 64 days, anti-measles antibodies returned to baseline in all patients.

Immunity against measles was temporarily reduced by apheresis but remained detectable in most patients at time of transplantation.

Desensitization maintains long-term protective immunity against measles.