Evidence map›Paper›PMID 40873926›Full record

ArticleCureus2025

ABO Antibody Titer Dynamics and Optimization in Incompatible Renal Transplants Using Therapeutic Plasma Exchange.

Anubha Srivastava, Priti Elhence, Bharat Singh, Anupam Verma, Prashant Agarwal, Dheeraj Khetan, Rajendra K Chaudhary, Aneesh Srivastava, Narayan Prasad

Abstract read
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Anubha SrivastavaTransfusion Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, IND.
Priti ElhenceTransfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND.
Bharat SinghTransfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND.
Anupam VermaTransfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND.
Prashant AgarwalTransfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND.
Dheeraj KhetanTransfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND.
Rajendra K ChaudharyTransfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND.
Aneesh SrivastavaUrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND.
Narayan PrasadNephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, IND.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background ABO-incompatible kidney transplantation (ABOi KT) expands access to living-donor organs but requires careful control of pre-existing anti-ABO isoagglutinins to minimize antibody-mediated rejection (ABMR). The present study was designed with the following objectives: The primary objective was to assess the relationship between baseline anti-ABO IgG titers (≥ 64 vs. < 64) and the intensity of therapeutic plasma exchange (TPE) required pre- and post-transplant, as well as ABMR incidence. The secondary objective was to evaluate graft function, patient and graft survival, and the frequency and severity of TPE-related adverse events using a standardized TPE-based desensitization protocol in a resource-limited center. Methods In this prospective single‑center study, 20 dialysis‑dependent recipients of live‑related ABOi KT received tacrolimus‑based immunosuppression, TPE, intravenous immunoglobulin, rituximab, and anti‑thymocyte globulin. ABO IgG and immunoglobulin M titers were monitored serially. Patients were stratified by high (≥64) versus low (<64) baseline IgG titers. Primary outcomes were pre‑ and post‑transplant TPE requirements and ABMR incidence; secondary outcomes included graft function, patient and graft survival, and TPE‑related adverse events. Results Across the cohort, 144 TPE sessions were performed. Recipients with high baseline IgG titers required more pretransplant TPE than those with low titers (mean 5.2 ± 1.75 standard deviation vs 3.4 ± 1.3; p = 0.02), whereas post‑transplant TPE use was comparable. ABMR occurred in 45 % of patients and was more frequent in the high‑titer group, though the difference was not statistically significant. Most recipients maintained stable graft function at 24 months, patient survival was high, and TPE‑related adverse events were infrequent and mild. Conclusions Higher baseline IgG titers increase the need for pretransplant desensitization but do not drive additional post‑transplant TPE. An individualized, TPE‑centered protocol can safely and effectively enable ABOi KT in resource‑constrained settings, underscoring the value of risk‑adapted strategies and real‑time immunomonitoring to optimize transplant outcomes.

Indexed as

abo-incompatible kidney transplantantibody-mediated rejectionimmunohematologypatient outcomestherapeutic plasma exchangetransfusion medicine

Identifiers

PMID40873926
PMCPMC12379559

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.