501C - Research Paper

Abstract
Case Description:
We describe a case where despite frequent plasma exchange, anti-A antibody titres continued to rise after transplant and antibody mediated rejection developed. Using a glucosorb column we treated 7 plasma volumes during 9 hours . We repeated this a further 4 times over 10 days. 

Discussion:
A 50 year old male with a history of Polycystic Kidnety disease recieved a Living related ABO incompatible transplant. Despite conventional treatment the antibody titre continued to rise. It was decided to perform large volume plasma exchange with specific antibody adsorbing columns. Large volme exchange is not without its complications. The patient expeienced alkalosis . hypocaleamia and fluid gain . Despite these initial complications the patient recoverd and remains off dialysis

Conclusion:
High volume plasma exchange with immunadsotption is  effective in reducing antibody titres where conventional plasma exchange has failed.It is tokerated by the patient. It requires trained, skilled and motivated staff