Acute vascular rejection treated by plasma exchange.

Since 1980 we have treated in 14 patients 19 steroid resistant acute vascular rejection (AVR) episodes by plasma filtration (PF). Each episode was treated by six PF with 5L plasma being filtered and simultaneously replaced by 3.5 per cent Albumin-Ringer-lactate. After each PF 20g immunoglobulin (Intraglobin) was given intravenously. In all cases renal function improved following PF. In the long term one graft was lost due to chronic irreversible vascular rejection, all others are still functioning, nine of them six months and eight of them 12 months post PF treatment. They show no signs of rejection. PF with repletion of immunoglobulins after treatment is a simple and safe procedure, which in our hands proved to be quite effective in reversal of AVR.