双重滤过血浆置换去除ABO血型不相容肾移植受者血型抗体及其对移植肾存活的影响研究*

doi:10.3969/j.issn.1672-5069.2026.02.021

实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (2): 245-248.doi: 10.3969/j.issn.1672-5069.2026.02.021

双重滤过血浆置换去除ABO血型不相容肾移植受者血型抗体及其对移植肾存活的影响研究^*

江守伟, 胡东燕, 沈强, 李文渊, 何宏亮

230001 合肥市中国科学技术大学附属第一医院(安徽省立医院)感染性疾病科

收稿日期:2025-05-20 出版日期:2026-03-10 发布日期:2026-03-13
通讯作者: 何宏亮,E-mail:hhl725@ustc.edu.cn
作者简介:江守伟,男,医学硕士。E-mail:61747533@qq.com
基金资助:
^*北京肝胆相照公益基金会“人工肝专项基金”资助项目(编号:RGGJJ-2021-002);安徽省临床重点专科建设项目(安徽省立医院)

Application of double filtration plasmapheresis in ABO-incompatible kidney transplantation: An analysis of 80 cases

Jiang Shouwei, Hu Dongyan, Shen Qiang, et al

Department of Infectious Diseases, First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China

Received:2025-05-20 Online:2026-03-10 Published:2026-03-13

摘要/Abstract

摘要： 目的探讨双重滤过血浆置换(DFPP)去除ABO血型不相容肾移植(ABOi-KT)受者血型抗体的作用及其对移植肾存活的影响。方法 2020年1月～2021年12月我院诊治的肾衰竭患者80例,其中接受血浆置换(PE)18例,接受DFPP治疗62例,均接受ABOi-KT。采用卡式柱凝集法测定血清抗A/B IgM和IgG型抗体。结果在DFPP组治疗后,除了IgM抗-B抗体外,其余血型抗体效价均有显著下降,PE组仅IgG抗-A出现明显下降,但两种方法对抗体的整体去除效果无显著性差异;在围术期,两组均未出现与治疗相关的不良反应;中位随访38.2个月,PE组所有受体均未出现移植失败,患者均生存,在DFPP组中有3例(4.8%)在肾移植术后3～22个月内出现移植肾衰竭,有4例(6.4%)患者死亡。结论采取DFPP治疗去掉血型抗体施行ABOi-KT安全、有效。

关键词: 双重滤过血浆置换, 血浆置换, ABO血型不相容, 肾移植

Abstract: Objective The aim of this study was to investigate the safety and clinical efficacy of double filtration plasmapheresis (DFPP) in ABO-incompatible kidney transplantation (ABOi-KT). Methods 80 patients with renal failure were encountered in our hospital between January 2020 and December 2021, all received ABOi-KT, and underwent DFPP in 62 cases, and underwent plasma exchange (PE) in 18 cases for removal of blood type antibodies before KT. Serum A/B IgM and IgG antibodies were determined by column agglutination technology (CAT). Result In DFPP group, serum antibody titers of all blood types decreased significantly after removal, except for serum IgM anti-B antibody; in the PE group, only serum IgG anti-A showed remarkably decreased; there was no significant difference as respect to overall removal of serum antibodies between the two methods; there were no removal-related adverse reactions in the perioperative period in either group; three patients (4.8%) in the DFPP group experienced dysfunctions of the transplanted kidney, and four patients (6.4%) died. Conclusion DFPP exhibits efficacious and safe for removal blood type antibodies before ABOi-KT, which warrants further clinical investigation.

Key words: Double filtration plasmapheresis, Plasma exchange, ABO incompatibility, Kidney transplantation

江守伟, 胡东燕, 沈强, 李文渊, 何宏亮. 双重滤过血浆置换去除ABO血型不相容肾移植受者血型抗体及其对移植肾存活的影响研究^*[J]. 实用肝脏病杂志, 2026, 29(2): 245-248.

Jiang Shouwei, Hu Dongyan, Shen Qiang, et al. Application of double filtration plasmapheresis in ABO-incompatible kidney transplantation: An analysis of 80 cases[J]. Journal of Practical Hepatology, 2026, 29(2): 245-248.

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双重滤过血浆置换去除ABO血型不相容肾移植受者血型抗体及其对移植肾存活的影响研究^*

Application of double filtration plasmapheresis in ABO-incompatible kidney transplantation: An analysis of 80 cases

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