On treating patient with plasma exchange, corticosteroids, cyclophosphamide and mycophenolate mofetil CM MF), an immediate decline in titer i nhi bitors can be obtained as a result of plasma replacement, and prog ress can be sustained with long-term moderate immunosuppression with MMF preced. by one injection of IV cyclophosphamide..

Severe ABO incompatible TPE is performed to remove ABO antibodies and permit ABO-incompatible (ABO-I) kidney transplants, but there is only limited research within this area and a lack of standardized protocols for TPE.. It is the naturally occurring antibodies that are produced against ABO antigens that are not present in one's own tissues that are key mediators of Antibody-mediated Rejection (AMR) and prevent renal transplantation across ABO barriers. The ABO blood group transplantation barrier was revered as insurmountable until recently due to initially poor experiences crossing the barrier.. ABO-I kidney transplantation is currently an ASFA Category II indication for TPE. TPE treatment plan is based on the anti-A and anti-B titers with the goal of achieving ABO titer at the AHG phase of 16 or less before surgery.