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Dialyse aktuell 2013; 17(10): 550-554
DOI: 10.1055/s-0034-1367708
Nephrologie
© Georg Thieme Verlag Stuttgart · New York

Immunadsorption und Plasmapherese bei Glomerulonephritiden und Nierentransplantation – Wird die Immunadsorption die Plasmapherese ersetzen?

Immunoadsorption and plasmapheresis for glomerulonephritides and renal transplant indications – Will immunoadsorption replace plasmapheresis?
Christian Morath
1   Nierenzentrum Heidelberg (Chefarzt: Prof. Dr. Martin Zeier)
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Publication History

Publication Date:
20 January 2014 (online)

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Zusammenfassung

Immunadsorption (IA) und Plasmapherese (PP) erlangen zunehmend an Bedeutung bei der Behandlung von Autoimmunerkrankungen sowie im Bereich der Nierentransplantation. Beide Verfahren können schnell und effektiv Immunglobuline und Immunkomplexe aus dem systemischen Kreislauf entfernen und werden somit zum Beispiel bei systemischem Lupus erythematodes oder zur Entfernung von humanen Leukozytenantigenen (HLA) oder Anti-A/B-Antikörpern bei Nierentransplantationen eingesetzt. Die PP ist zudem in der Lage, weitere Moleküle inklusive Toxine zu eliminieren oder aber fehlende Plasmakomponenten zu ersetzen, zum Beispiel bei(m) hämolytisch-urämischen Syndrom (HUS)/thrombotisch-thrombozytopenischer Purpura (TTP). Limitiert sind diese beiden extrakorporalen Verfahren durch den damit verbundenen Aufwand, die Kosten und die zum Teil immer noch fehlende Evidenz. Somit muss das Ziel sein, im Rahmen von Studien weitere wissenschaftliche Grundlagen für diese vielversprechenden Therapien zu schaffen.

Summary

Immunoadsorption (IA) and plasmapheresis (PP) are now widely used for autoimmune as well as transplant indications. Both procedures allow for rapid elimination of immunoglobulins and immune complexes from the systemic circulation. Therefore, IA and PP are used for example in the treatment of systemic lupus erythematosus or for the removal of human leukocyte antigen (HLA) or anti-A/B antibodies before and after kidney transplantation. PP in addition may remove other substances than immunoglobulins such as toxins. A limitation is the complexity of both procedures as well as the high cost and limited evidence. The goal for the near future is to establish more evidence for these promising therapies.

Key words

plasmapheresis - immunoadsorption - kidney - glomerulonephritis - transplantation - immunoglobulins
 

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