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Table 3 Advantages and disadvantages of various methods of antibody removal (

From: Novel double-filtration plasmapheresis preserves fibrinogen while removing immunoglobulin-G antibodies before ABO blood type-incompatible kidney transplantation

  Supplement fluid Advantages Disadvantages
TPE FFP or crystalloid with albumin solution Simple Nonselective elimination of other plasma components
Readily available Application of FFP is necessary with risk of subsequent infections or anaphylactic reactions
Simultaneous elimination of ABO Abs and HLA Abs, immune-complexes, and unknown circulating factors
Relatively low costs
DFPP Crystalloid with albumin solution Selective (only elimination of high molecular weight plasma fractions) Elimination of other plasma components
Simultaneous elimination of ABO Abs and HLA Abs, immune-complexes, and unknown circulating factors Low biocompatibility of the cascade filter Evaflux 2A (Kuraray, Kurashiki, Japan)
No application of FFP needed
Glycosorb-IA (antigen-specific) Unnecessary Most selective No elimination of HLA Abs
Simple to use technique In blood type O recipients and AB donors, AB two different columns are needed
Elimination of both IgG and IgM antibodies for ABO antigens Short shelf life
No replacement fluid is needed High costs
Immunosorba-IA (nonantigen-specific) Unnecessary Selective but less than Glycosorb Elimination of all Ig fractions
Simultaneous elimination of ABO Abs and HLA Abs Different affinity for various Ig-subtypes (insufficient removal of IgG3 and IgM)
No replacement fluid is needed Rarely anaphylactic reactions triggered by staphylococcus-protein A
High costs
Ig Therasorb-IA (nonantigen-specific) Unnecessary Selective but less than Glycosorb Removal of all Ig-fractions
Simultaneous elimination of ABO Abs and HLA Abs High costs, but less costs with double-columns system
Elimination of all Ig-fractions
36 months shelf live
High removal capacity
No replacement fluid is needed
Selective PE Crystalloid with albumin solution Simple Almost no Elimination of IgM-fraction
Readily available Elimination of IgG-fractions less than TPE and DFPP
Elimination of IgG-fractions
Fibrinogen mostly preserved
No application of FFP needed
  1. ABO Abs ABO antibodies, DFPP double-filtration plasmapheresis, FFP fresh frozen plasma, HLA Abs human leukocyte antigen antibodies, IA immunoadsorption, Ig immunoglobulin, TPE therapeutic plasma exchange