The safety measures for double filtration plasma apheresis (DFPP) before ABO-incompatible kidney transplantation

Double filtration plasma apheresis (DFPP) is an essential procedure for the success of ABO-incompatibility kidney transplantation. During DFPP treatment serum albumin fraction decreases as well as serum globulin fraction, therefore the drop of colloidal oncotic pressure induces intravascular dehydration. We raised the concentration of albumin solution as supplementation fluid from 7.5% to 12.5%. In DFPP treatment with 7.5% albumin supplementation solution, the reduction rate of serum albumin concentration, pre-albumin/post-albumin, was 0.821 (p < 0.05, n = 8), however, in DFPP treatment with 12.5% albumin supplementation solution, the rate of change of serum albumin concentration was 1.054 (p = ns, n = 7). This insignificant change of serum albumin concentration resulted in the prevention of hypotension and other complications associated with intravascular dehydration derived from the drop of oncotic pressure due to DFPP treatment. Twelve and a half percent albumin solution as supplementation fluid is recommended for DFPP treatment before ABO-incompatible kidney transplantation.