ABOi肾移植O型受者围术期血型抗体变化分析
Changes in blood type antibody of type-O recipients with ABO-incompatible kidney transplantation during perioperative period
靳慧芳 1孔永奎 1刘欣 1王书亚 1谢莹 1陈李影慧 1刘雪 1刘爱萍 1杨乾坤1
作者信息
- 1. 郑州大学第一附属医院输血科,郑州 450052
- 折叠
摘要
目的 分析ABO血型不相合肾移植(ABOi-KT)O型受者的围术期资料,探讨ABOi-KT受者血型抗体变化趋势.方法 回顾性分析郑州大学第一附属医院2021年1月-2023年9月32例首次肾移植、血型O型受者的临床资料,依据供者血型不同,分为A供O组(n=17)和B供O组(n=15).分析比较血浆置换对术前两组受者血型抗体的清除效果、术后两组血型抗体反弹和肾功能[术后第1、3、7、14天的尿素氮、肌酐和肾小球滤过率(estimated glomerular filtration rate,eGFR)]的差异.结果 术前血浆置换对受者抗A-IgG抗体的清除率低于抗B-IgG抗体(Z=-2.238,P=0.025),而IgM抗体的清除率在两组间差异无统计学意义(Z=-1.911,P=0.056);A供O组术后更易出现血型抗体滴度反弹(P=0.018),但术后第1天、3天、7天、14天两组肾功指标差异均无统计学意义.结论 与B供O组相比,A供O组ABOi-KT需要更加谨慎,因为围术期内抗A-IgG抗体清除相对困难且术后更易发生血型抗体滴度反弹.
Abstract
Objective To analyze the perioperative results in type-O recipients with ABOi-KT,to explore the changes in blood type antibody of ABO-incompatible kidney transplantation(ABOi-KT)patients.Methods From January 2021 to September 2023,clinical data of 32 cases of blood group O ABOi-KT recipients in our hospital were retrospec-tively analyzed,and patients were divided into two groups(A:n=17,B:n=15)according to the different blood types of donors.The effects of preoperative plasmapheresis on antibody titer,antibody rebound and renal function after opera-tion(serum urea nitrogen,creatinine and estimated glomerular filtration rate on the 1st,3rd,7th and 14th day)were compared between the two groups.Results The clearance rate of anti-A IgG was lower than that of anti-B IgG(Z=-2.238,P=0.025),while no significant differences was found in clearance rate of Anti-A/B IgM between the two groups(Z=-1.911,P=0.056).There was no significant difference in levels of serum urea nitrogen,creatinine and eGFR at each observation point between the two groups(P＞0.05).In addition,group A was more prone to rebound antibody when compared with group B(P=0.018).Conclusion ABOi-KT in group A required greater caution com-pared to the group B because of the lower clearance rate of anti-A IgG and the higher tendency of antibody rebound.
关键词
ABO血型不相合肾移植/血浆置换/抗体滴度/围术期Key words
ABO-incompatible kidney transplantation/Plasmapheresis/Antibody titer/Perioperative period引用本文复制引用
基金项目
河南省医学科技攻关计划项目(2018020026)
出版年
2024
NETL
NSTL
万方数据