双重滤过血浆单采清除肾移植术前群体反应性抗体临床疗效及安全性观察  

Efficacy and Safety of Double Filtration Plasmapheresis to Remove High PRA Antibody before Kidney Transplantation

作　　者：刁玉洁 朱帮强[1] 闻慧琴[1] 王海婧[1] 胡艳[1] 程越[1] 卞茂红[1] DIAO Yujie;ZHU Bangqiang;WEN Huiqin;WANG Haijing;HU Yan;CHENG Yue;BIAN Maohong(Department of Blood Transfusion,the First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院输血科,230022

出　　处：《临床输血与检验》2024年第1期49-54,共6页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的观察双重滤过血浆单采(double filtration plasmapheresis,DFPP)在清除肾移植术前群体反应性抗体(panel reactive antibody,PRA)的临床疗效及安全性。方法回顾分析2021年1月—2023年6月,本院11例肾移植术前PRA阳性患者行DFPP治疗后PRA变化情况,监测治疗前后血常规、肝功能和止凝血等参数。结果11例终末期肾衰竭患者经DFPP治疗后PRA明显下降,由阳性转为阴性或者弱阳性,除1例患者因一般情况较差,放弃肾移植手术,其余患者顺利进行肾移植手术。患者共进行了62次DFPP治疗。分析显示,患者在行DFPP治疗前后相比,RBC、HB、PLT、ALB、TBIL、PT、APTT、K、Na、Cl、HCO_(3)^(–),差异无明显变化(P>0.05)。结论DFPP有效地降低了患者肾移植术前高PRA指标和降低肾移植术后急性排斥反应的风险,且治疗过程安全。Objective To observe the clinical efficacy and safety of double filtration plasmapheresis(DFPP)in clearing panel reactive antibody(PRA)before renal transplantation.Methods The changes of PRA in 11 patients with PRA positive before kidney transplantation and after DFPP treatment in our hospital from January 2021 to June 2023 were retrospectively analyzed.Parameters such as routine blood,liver function and anticoagulation were monitored before and after treatment.Results PRA in 11 patients with end-stage renal failure decreased significantly after DFPP treatment,from positive to negative or weakly positive.Except for one patient who gave up kidney transplantation because of poor general conditions,the other patients underwent kidney transplantation successfully.Sixty-two DFPP treatments were performed.There were no significant changes in RBC,HGB,PLT,ALB,TBIL,PT,APTT,K,Na,Cl,HCO_(3)^(–)compared with patients before and after DFPP treatment(P>0.05).Conclusion DFPP can effectively reduce the high PRA index before renal transplantation and reduce the risk of acute rejection after renal transplantation,and the treatment process is safe.

关 键 词：肾移植 双重滤过血浆单采 群体反应性抗体 

分 类 号：R457[医药卫生—治疗学]