Abstract: Objective To observe the clinical efficacy and safety of double filtration plasmapheresis (DFPP) in clearing panel reactive antibody (PRA) before renal transplantation. Methods The changes of PRA in 11 patients with PRA positive before kidney transplantation and after DFPP treatment in our hospital from January 2021 to June 2023 were retrospectively analyzed. Parameters such as routine blood, liver function and anticoagulation were monitored before and after treatment. Results PRA in 11 patients with end-stage renal failure decreased significantly after DFPP treatment, from positive to negative or weakly positive. Except for one patient who gave up kidney transplantation because of poor general conditions, the other patients underwent kidney transplantation successfully. Sixty-two DFPP treatments were performed. There were no significant changes in RBC, HGB, PLT, ALB, TBIL, PT, APTT, K, Na, Cl, HCO₃^- compared with patients before and after DFPP treatment (P>0.05). Conclusion DFPP can effectively reduce the high PRA index before renal transplantation and reduce the risk of acute rejection after renal transplantation, and the treatment process is safe.

Key words: Kidney transplant, Double filtration plasmapheresis, Panel reactive antibody