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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 investigate the effect of plasma exchange (PE) in high-sensitivity recipients before kidney transplantation. Methods: Twelve patients with hypersensitivity recipients were treated with PE prior to renal transplantation and 37 patients with hypersensitivity recipients were not treated with PE. The incidence of rejection in two groups of renal transplant recipients was observed. Results: The PRA value of PE group was 71.0% ± 19.1% before replacement and 34.3% ± 17.9% after replacement, both of which were significantly different (P <0.01). There were 2 cases of superovulation and 2 cases of acute rejection after operation. There were 2 cases of superovulation and 8 cases of acute rejection in PE group. There was no significant difference in the incidence of superovulation and acute rejection between the two groups. Conclusion: PE has no significant effect on preventing superovulation and reducing the incidence of acute rejection. The primary indication for PE therapy is that recipients of more than 80% of PRA can rapidly reduce PRA and contribute to HLA antibody-specific analysis and HLA typing.