高敏受者肾移植术前行血浆置换的临床探讨  

CLINICAL RESEARCH ON PLASMA EXCHANGE FOR HIGHLY SENSITIZED RECIPIENTS BEFORE RENAL TRANSPLANTATION

作　　者：袁小鹏[1] 焦伟华[1] 高伟[1] 

机构地区：[1]广东省东莞市太平人民医院器官移植科,523905

出　　处：《中国现代医学杂志》2003年第16期21-22,25,共3页China Journal of Modern Medicine

摘　　要：目的 :探讨高敏受者肾移植术前行血浆置换 (PE)的效果。方法 :12例高敏受者在肾移植术前进行PE治疗 ,37例高敏受者未行PE治疗 ,观察两组肾移植病人排斥反应发生率的差异。结果 :PE组置换前PRA值71.0 %± 19.1% ,置换后 34.3%± 17.9% ,两者有显著性差异 (P <0 .0 1)。术后发生超排 2例 ,急性排斥 2例 ;未行PE组发生超排 2例 ,急性排斥 8例 ,两组间超排和急性排斥的发生率均无显著性差异。结论 :PE对预防超排和降低急性排斥的发生率均无明显作用。PE治疗的主要适应症为PRA大于 80 %的受者 ,能快速降低PRA值 ,有助于HLA抗体特异性分析和HLA配型。Objective:To explore the effect of plasma exchange(PE) on highly sensitized recipients before renal transplantation. Methods:Twelve highly sensitized recipients were treated with PE before renal transplantation and 37 highly sensitized recipients without PE. The rate of hyperacute and acute rejection was observed. Results:PE therapy decreased PRA levels significantly(71.0%±19.1% vs.34.3%±17.9%). There was no significant difference in the rate of hyperacute and acute rejection between PE group and control group (2/12 vs. 2/37 and 2/10 vs. 8/35).Conclusions:PE has no significant effect on the rate of hyperacute and acute rejection in highly sensitized recipients. The main candidates for PE therapy are recipients with PRA>80%. PE therapy can decrease PRA level effectively and it is helpful to identify the antibody specificity and select a donor according to HLA matching.

关 键 词：高度致敏受者 肾移植 血浆置换 

分 类 号：R699.1[医药卫生—泌尿科学]