Removal of anti-A and anti-B antibodies from individuals should allow for renal organ transplantation without the restriction of ABO matching. The proposed device would accomplish this in a simple, highly biocompatible way, and with greater efficacy than other methods. This device consists of a hollow fiber filter system similar to traditional renal dialysis with synthetic blood group A and B substances attached to the lumenal surfaces. The ABO incompatible recipient would have their blood passed through the filter in a similar fashion to routine renal dialysis. Anti-A and anti-B antibodies will bind to the blood group A and B substances lining the lumenal surface of the filter. If high levels of anti-A and anti-B antibodies are [lowered to 1:2 level] in the peritransplant period, hyper- acute rejection can be eliminated and graft survival can be accomplished. The advantage of this technique included the increased biocompatibility achieved by the removal of antibody from whole blood as opposed to plasmapheresis followed by treatment with beaded columns and additionally the unique flow characteristics of hollow fibers allow for increased removal of antibodies via ultrafiltration. The device would increase the pool of living related and unrelated donors.
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Hout, M S; LeJeune, K E; Schaack, T M et al. (2000) Specific removal of anti-A and anti-B antibodies by using modified dialysis filters. ASAIO J 46:702-6 |