双滤过法血浆分离治疗移植肾术后排斥反应及术前高度致敏

目的探讨肾移植术后排斥反应和术前高度致敏的治疗方法。方法采用双滤过法血浆分离术（ＤＦＰＰ）治疗３６例术后排斥反应和９例术前高度致敏患者。结果２４例急性排斥中２２例逆转，１０例加速性排斥（ＡＣＲ）全部逆转，１例慢性排斥肾功能稳定，１例超急性排斥（ＨＡＲ）摘除移植肾；排斥反应采用ＤＦＰＰ治疗者其一年移植肾生存率为８４．０％。去致敏抗体者８例已接受肾移植，其中１例术后发生ＨＡＲ。结论认为ＤＦＰＰ是治疗排斥反应和预防高敏患者术后发生致敏抗体介导的ＨＡＲ和ＡＣＲ的有效方法，显著提高了排斥反应的逆转率和移植肾生存率

Treatment of rejection and highly sensitized in kidney transplantation with double filtration plasmapheresis

Objective To investigate the treatment of rejection and highly sensitized in the renal allograft.Methods Double filtration plasmapheresis (DFPP)was used to treat 45 patients. Among them, 36 patients, who were resistance to high dose corticosteroids and antilymphocyte agents, were treated for rejection, and 9 sensitized patients (>50% PRA) underwent the treatment of removing the antibody before the kidney transplantation.Results Among the 24 cases of acute rejection, 94% rejection crises were reversed by DFPP. The one year survival rate of the allografted renal in rejection patients receiving DFPP treatment was 84.0 %. Eight sensitized patients of removing the antibody had received renal transplantation.Conclusion DFPP was an effective procedure for the treatment of rejection and for the prevention of hyperacute rejection and ACR mediated by sensitizing antibody following transplantation.