Use of lymphoplasmapheresis or plasmapheresis in the management of acute renal allograft rejection.

Several recent reports have documented the value of intensive plasmapheresis as an adjunct to standard immunosuppressive therapy for patients suffering acute renal allograft rejection. We have treated four rejection episodes in three patients with intensive plasmapheresis and two rejection episodes in two additional patients with intensive lymphoplasmapheresis. Five of six rejection episodes were reversed, and four of the five patients treated have retained functioning grafts for follow-up periods ranging from 4 months to 3 years. Previous investigators have reported encouraging results using plasmapheresis, and we believe our experience supports the requirement for further controlled studies with this procedure. Moreover, we note that no previous work has been described with lymphoplasmapheresis and suggest that removal of lymphocytes, in addition to plasma, may further augment immunosuppression in the treatment of renal allograft rejection.