血浆置换治疗对高敏患者肾移植后排斥反应的影响

目的 探讨血浆置换(PE)减少高敏患者肾移植后排斥反应的疗效。方法 46例肾移植前群体反应性抗体(PRA)阳性≥30%(30%～88%)患者,先作血浆置换治疗1～3次后,当PRA<30％才作尸体肾移植作治疗组。30例PRA阳性,强度≥30％(30％～77％)患者进行尸体肾移植作对照组。比较2组患者术后6个月内排斥反应情况。结果 对照组术后排斥反应发生率为63.3％(19/30)。治疗组移植后排斥反应发生率为21.7%(10/46),(P<0.001)。结论 PE治疗能明显减少有预先形成抗体的高敏患者的肾移植后排斥反应,疗效满意。

Influence of plasma exchange therapy on renal transplant rejection in highly sensitive recipients

Objective To investigate the effect of plasma exchange(PE) therapy on reducing renal transplantation rejection in highly sensitive recipients. Methods Rejections within 6 months after renal transplantation were compared between the two groups of patients,one of which was composed of 30 recipients whose panel reactive antibody levels before the transplantation were from 30% to 77% ,and another was composed of 46 recipients whose panel reactive antibody levels were from 30% to 88%. The later group of patients received PE therapy before transplantation and had not undergone renal transplantation operation until their panel reactive antibody levels were below 30% or negative. Results After transplantation,the rejection incidence was 63. 3% (19/30) for those 30 recipients without plasma exchange therapy and 21.7% (10/46) for the 46 recipients receiving plasma exchange therapy respectively. The difference was very significant(P<0.001). Conclusion For the highly sensitive recipients who have the pre-transplant antibodies,plasma exchange therapy can significantly reduce the post - transplant rejection incidence.