Objective To explore the clinical efficacy of immunoadsorption in highly sensitized kidney transplant(KT)candidates.Methods From September 2019 to April 2023,the relevant clinical data were retrospectively reviewed for 26 highly sensitized KT recipients.Protein A immunoadsorption desensitization therapy was offered after KT.The effect of immunosorbent on reducing anti-human leukocyte antigen(HLA)antibodies was summarized.And operative success rate and postoperative complication incidence were calculated.Results The mean number of treatment session was(10.76±5.53).The highest level of HLA-Ⅰ antibody mean fluorescence intensity(MFI)dropped from(17921±4 442)to(7 333±6 434)with a decline of 59％and HLA-Ⅱ antibody MFI decreased from(21135±5 245)to(10 989±7 627)with a decline of 48％.The differences were statistically significant(both P＜0.001).All kidneys were harvested from cadavers.The complications were acute antibody mediated rejection(7 cases),perioperative pulmonary infection(3 cases)and myelosuppression(2 cases).The average follow-up period was(30.8±12.6)month.The graft survival rate was 88.5％(23/26)and the recipient survival rate 100％(26/26).Conclusions Immunoadsorption therapy can effectively reduce HLA antibody in highly sensitized KT candidates,thereby increasing the probability of successful KT.In terms of safety,immunosorbent therapy may boost the potential risks of infection and myelosuppression.It requires heightened attention.
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