Plasmapheresis and IVIG post-transplant

[Fox_nc]

I've seen several posts where people have had plasmapheresis and IVIG treatments as a part of the initial transplant surgery, but has anyone had it with an established transplant? I had my very first set of treatments about a year and a half into my current transplant.

Also - I saw a couple posts where some women had this treatment because their donor was their husband and they had children together.  My donor was also my husband, but I am unable to have children - so no problem there.  We were almost a perfet match but now I have Donor Specific Antibodies - I know this seems weird, but I'm wondering if its being caused not by the kidney, but by my body producing antibodies to kill sperm. Thoughts?

[Beth36]

My mom had a positive crossmatch transplant at Mayo 2 years ago. Her antibodies were high (they assume) because she had 4 children. My youngest sister was her donor and before my mom could have the transplant, she had to have plasmapheresis and IVIg to lower her antibodies enough to get a negative crossmatch. Once she had her transplant, she still had a few treatments after but I think she just did plasmapheresis and not IVIg after the transplant. She also was given a then experimental drug (she was the first person to be given this drug with a kidney transplant and it's since been approved for use in positive crossmatch transplants) called eculizmab for a week. It was by IV. Two years later, her kidney is fine and she's doing great. As far as the donor specific antibody, I'm not sure....I don't know and I'm sorry I can't answer that part of the question. I wish you luck with your transplant, though! Hope you have smooth sailing and an easy recovery and that your husband does, too!

[okarol]

When they biopsy a kidney that is having a rejection episode they can identify the cells that are having trouble. Depending on what it is they can rescue the kidney with IVIG, plasmapheresis, prednisone and ATG infusions (sometimes one or another or a combination of those treatments.) Did they tell you what they were hoping to achieve? Had you gotten a biopsy or labs that concerned them?

[renalpenguin]

I have FSGS- it recurred minutes after my transplant, but with five plasmapheresis treatments (and plenty of prayer!) I went into remission the next day. I'm only two weeks post-transplant now, but for the last ten days, I've had negative protein readings everytime. I know it could still come back (I mean, I'm only two weeks out!) but my doctor and I are very hopeful we've seen the last of FSGS... and if we haven't it seems plasmapheresis works for me.

[Fox_nc]

When they biopsy a kidney that is having a rejection episode they can identify the cells that are having trouble. Depending on what it is they can rescue the kidney with IVIG, plasmapheresis, prednisone and ATG infusions (sometimes one or another or a combination of those treatments.) Did they tell you what they were hoping to achieve? Had you gotten a biopsy or labs that concerned them?

Well it started with protein in my urine with elevated creatine and a biopsy showed the FSGS.  I then had 10-15 plasma treatments and some IVIG and my protein goes back to normal. I'm not sure at what point the DSA came into play, but they are checking my antibody levels pretty regular. I'm averaging one of these dances about every 6 months (Feb 09, Oct 09, May 10) which is why I'm having the fistula surgery.

They are hoping to prolong this kidney without doing so much to it that it would endanger a future transplant. This last time they added an experimental IV treatment - I don't remember the name right now but it's normally used as chemotheraphy - yay! It seems we may be doing plasmaphersis on a regular basis.

[MooseMom]

We were almost a perfet match but now I have Donor Specific Antibodies - I know this seems weird, but I'm wondering if its being caused not by the kidney, but by my body producing antibodies to kill sperm. Thoughts?

Oh, what a fascinating question!!!!!  I have no idea what the answer is, but if you ever find out, PLEASE let me know!  Have you asked your doctors?  I'd love to hear what they have to say in this regard.

[Fox_nc]

I haven't asked them yet - it just occured to me while reading some other posts over the weekend. But, believe me I will ask the first chance I get and let you know!