Plasmapheresis is a process that removes harmful antibodies from the blood so they don’t attack and damage the new kidney. It is a procedure similar to dialysis that removes the plasma portion of the blood where antibodies are located. The number of plasmapheresis treatments required by the recipient before surgery varies depending on the amount of harmful antibodies in their blood.
After each plasmapheresis the recipient receives an intravenous infusion of immune globulin to replace antibodies needed to fight infections and help prevent harmful antibodies from returning. Once the antibodies against the donor’s blood type decrease to very low levels, the transplantation can take place.
To prevent the antibodies from returning and damaging the kidney, the recipient has several plasmapheresis treatments and doses of immune globulin after the transplant. In addition, the recipient’s spleen may be removed during the transplant procedure through tiny incisions. The spleen is the organ where antibodies are produced. Some antibodies may return after the transplant but do not appear to damage the new kidney.