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. Author manuscript; available in PMC: 2013 Apr 1.
Published in final edited form as: Semin Immunol. 2011 Sep 21;24(2):136–142. doi: 10.1016/j.smim.2011.08.015

Fig. 2.

Fig. 2

The Johns Hopkins PP/IVIG desensitization protocol. The protocol utilizes every other day plasmapheresis along with low-dose IVIG (100 mg/kg). The number of pre-transplant PP/IVIG treatments can be predicted from the starting donor reactive antibody titer. Several post-transplant PP/IVIG treatments are performed by protocol. PP/IVIG treatments are added as needed to reduce antibody levels to pre-transplant targets or to treat an episode of antibody mediated rejection. In selective high-risk cases, anti-CD20 is given the night before the transplant. About 5% of +XM patients will require rescue splenectomy as part of the treatment for severe AMR. Used with permission[48].