EFFECT OF ERYTHROPOIETIN ON ANTI-HLA ANTI BODIES IN HIGHLY SENSITIZEDPATIENTS

Effect of erythropoietin on anti HLA-antibodies in highly sensitized p atients. - The use of erythopoietin (Epo) in chronic renal failure pat ients improves anemia and avoids iterative transfusions. As a conseque nce, a significant decrease of anti-HLA antibodies might be observed. From 31.12.1985 to 30.07.1991, among the 61 highly sensitized patients (pts) waiting for renal transplantation at our institution, 23 (7 men , 16 women, mean age 43,3+/-2,3 years) were treated with Epo during 21 ,4+/-1,7 months. After introduction of Epo, the mean number of transfu sions significantly decreased from 35+/-8 to 0,5+/-0,4 (p<0,0001) and the Panel Reactive Antibodies decreased from 88,1+/-1,7 to 18,8+/-5,6% (p<0,0001). HLA antibodies totally disappeared in 12 patients, decrea sed more than 30% in 9 patients and remained stable in the 3 others. R enal transplantation was performed in 9 patients; 4 with a negative cr oss-match in both historical and current sera and 5 with a negative cu rrent cross-match but with a positive historical cross-match. 6/9 pati ents are doing well with a good graft function; 2 patients returned to hemodialysis for rejection and 1 patient died with a functionning kid ney. Since Epo permits the transfusion withdrawal, its introduction in chronic renal failure treatment suppresses both the main factor of im munisation and one of the most important mechanisms of persistance of antibodies.