A new study has identified a blood-cleansing procedure known as therapeutic apheresis as a potential game-changer in kidney transplant management, raising fresh hope for patients facing transplant complications.
The six-year review, conducted at the University of Virginia Health in the United States and supported by the International Society of Nephrology, examined 131 kidney transplant patients who underwent 860 sessions of the therapy between 2017 and 2022.
Findings published in the Journal of Clinical Apheresis showed that the treatment is increasingly used to tackle antibody-mediated rejection — the leading cause of kidney transplant failure, responsible for nearly 70 per cent of cases studied.
Therapeutic apheresis, also called blood-cleansing or blood-filtering therapy, works by removing harmful antibodies and other elements in the blood that attack transplanted kidneys.
Researchers said it could be applied alone or combined with other therapies to prolong organ survival.
Although the procedure carries some risks, most complications were found to be minor and manageable.
Out of 860 sessions, 16.7 per cent recorded side effects, with hypocalcaemia, low calcium in the blood, being the most frequent, accounting for seven per cent. Other reported complications included mild hypotension, vascular blockages, arrhythmias, and depletion coagulopathy.
Despite these concerns, the outcomes were encouraging. About 73 per cent of patients remained dialysis-free after treatment, while 22 per cent eventually returned to dialysis or required another transplant. Only 8.4 per cent died during the period, with one death directly linked to the therapy, a rare rate of 0.12 per cent.
The study also revealed that most patients were aged between 40 and 59, with hypertension and focal segmental glomerulosclerosis identified as the leading causes of kidney failure before transplant.
The lead investigator and Chief Medical Director of Abia State Specialist Hospital and Diagnostic Centre, Dr. Chimezie Okwuonu said that the therapy is proving critical in improving post-transplant survival.
“The data confirms the growing importance of therapeutic apheresis as a cornerstone in preventing graft failure. While hypocalcaemia remains a concern, close monitoring and adherence to protocols allow patients to benefit significantly with minimal risks.”
The consultant nephrologist and a Fellow of the International Society of Nephrology, who pioneered transplant nephrology in Southeast Nigeria, urged that therapeutic apheresis be adopted as part of standard post-transplant care in the country.
“With transplant failures on the rise in Nigeria, resource-limited centres must begin to integrate this treatment into their protocols. Wider investment in apheresis technology is critical,” he added.
Dr. Okwuonu, who also serves as Clinical Care Coordinator and Quality Assessment Lead at FMC Umuahia, has been active in shaping kidney care policies in Nigeria.
He was part of the team that revised national guidelines for chronic kidney disease management in 2023 and helped develop the Ministry of Health’s new national framework for organ and tissue transplantation completed this year.
He currently sits on two key nephrology committees, on dialysis standards and acute kidney injury guidelines.