高敏受者肾移植术前双滤过法血浆分离治疗  

Double filtration plasmapheresis in highly sensitive kidney recipients

作　　者：黄洪锋[1] 陈江华[1] 王逸民[1] 吴建永[1] 张建国[1] 寿张飞[1] 朱丽亚[1] 袁静[1] 朱琮[1] 

机构地区：[1]浙江大学医学院附属第一医院肾移植血液净化中心,杭州310003

出　　处：《中华泌尿外科杂志》2000年第6期343-345,共3页Chinese Journal of Urology

摘　　要：目的　探讨双滤过法血浆分离 (DFPP)治疗肾移植术前群体反应性抗体 (PRA)高度致敏受者的疗效和安全性。　方法　对 19例高度致敏受者术前DFPP治疗情况进行分析。　结果　 4例病人PRA完全转阴 ,13例PRA降至可接受移植范围 (<40 % )。DFPP治疗前平均PRA水平为(5 9.3± 14.1) % ,治疗后下降至 (19.2± 18.9) % ,P <0 .0 5 ,平均下降 (40 .1± 19.2 ) %。DFPP治疗后4周复查PRA为 (2 1.9± 31.4) %。其中 17例已接受肾移植手术 ,术后发生超急性排斥 1例 (6 .3% ) ,急性排斥 6例 (35 .5 % ) ,经激素 抗淋巴细胞球蛋白 DFPP综合抗排斥治疗全部逆转。移植成功率达94.1% (16 / 17)。　结论　DFPP可降低肾移植高敏受者的排斥发生率 ,提高术后抗排斥治疗成功率 ,提高人 /肾长期存活率。Objective To evaluate doulbe filtration plasmaphoresis (DFPP) for highly sensitive kidney recipients. Methods DFPP was carried out before kidney transplantation for 19 highly sensitive recipients 〔Panel reactive antibody (PRA)>40%〕. Results In 13 patients,the PRA level decreased from (59.1±14.1)% to (19.2±18.9)% ( P <0.05),decreased by an average of (40.1±19.2)%. In the other 4 patients,PRA turned negative (PRA<10%).17 of them underwent renal transplantation.Hyperacute rejection occurned in 1.Acute rejection occurned in 6 but reversed on antirejection therapy. Conclusions DFPP renders the highly sensitive patients the chance of transplantation.It not only reduces the incidence of rejection but also increased the success rate of antirejection therapy.Long term outcome of the graft and patient is satisfactory.

关 键 词：肾移植 双滤过法血浆分离 PRA 排斥反应 治疗 

分 类 号：R699[医药卫生—泌尿科学]