M. J. Martinez et al.: J Extra Corpor Technol 2026, 58, 79--84 83
Figure
3. Diagram of the apheresis circuit connected to the CPB.
In summary, plasmapheresis during CPB offers easy access to cardiopulmonary bypass connections and stable volume management but requires special attention to the serum factors removed during plasmapheresis.
The frequency and volume of post-transplant plasmapheresis should be guided by the PRA results following each plasmapheresis procedure. Without aggressive post-transplant plasmapheresis and B-cell-specific immunosuppressive therapy, this procedure may have only a short-term effect due to a possible B-cell response to the allograft [ 14 ].
Conclusion
Therapeutic plasma exchange during extracorporeal circulation can serve as an adjunct to immunosuppression in the treatment or prevention of antibody-mediated rejection in solid organ transplants. TPE is a reproducible, safe, and effective technique. It may be indicated for sensitized patients on the heart transplant waiting list and, in combination with immunomodulatory therapies such as intravenous immunoglobulin before a transplant, can reduce the risk of rejection in HLAimmunized patients. This therapy was successfully performed for the first time in Argentina, in a public hospital, on a patient with congenital heart disease and a failed Fontan, with positive results.
Funding The authors did not receive funding to complete this research.
Conflicts of interest The authors declare no conflict of interest.
Data availability statement All available data are included in the article.
Author contribution statement
Matias Martinez: Original idea, writing, and layout of all the information in the article.
Matias Martinez, Ignacio Berra, and Fernando Zamora: Preparation, creation and / or presentation of the published work, specifically the writing of the initial draft( including substantive translation). Juan Costilla: Collaboration with the bibliography Pablo Garcia Delucis and Javier Cornelis: Supervision and validation during the preparation of each part of the article.
Ethics approval
Data collection was carried out through a retrospective cohort study to describe the case of the first heart transplant using plasmapheresis during CPB in Argentina. The patient’ s parents signed a consent form approved by the ethics committee of the Prof. Dr. Juan P. Garrahan Pediatric Hospital in Buenos Aires, Argentina. The scientific research adheres to ethical standards that promote and ensure respect for all human subjects and protect their health and rights.
References
1. American Association of Blood Banks. The HLA system. Technical manual. Chapter 19, 17th edn.; 2012.