Sensitized Kidney Transplantation Recipients Treated with Double Filtration Plasmapheresis plus Immunoadsorption Combined Interleukin-2-receptor Monoclonal Antibody:A Clinical Research

OBJECTIVE:To evaluate the clinical efficacy of double filtration plasmapheresis(DFPP)plus immune adsorption(IA)combined interleukin-2-receptor monoclonal antibody in the treatment of sensitized kidney transplantation recipients.METHODS:A total of 56 sensitized kidney transplantation recipients were enrolled:35 cases(trial group)were treated with DEPP plus IA combined interleukin-2-receptor monoclonal antibody,and another 21 cases(control group)were not given the above-mentioned treatment.Panel reactive antibody(PRA)in the sensitized kidney transplantation recipients was examined with ELISA.The incidences of acute rejection(AR)and delayed graft function(DGF)were compared between the two groups,and the patient/kidney 1 year survival rates and serum creatinine at 6 and 12 months were followed.RESULTS:In the trial group,PRA decreased significantly,with PRA in 14 cases turned to negative.In trial group vs.control group,the incidence of AR was 28.6% vs.42.9%(P0.05),DGF incidence was 8.6% vs.14.3%(P0.05);the 1 year survival rate of patients was 100.0% vs.95.2%(P0.05);and the 1 year survival rate of grafted kidneys was 94.3 % vs.76.2%(P0.05).The creatinine values at 6 and 12 month were(115.2±16.6)/(128.4±27.4)μmol·L-1 for the trial group vs.(121.2±28.6)/(134.6±33.7)μmol·L-1 for the control group(P0.05).CONCLUSION:DFPP plus IA combined interleukin-2-receptor monoclonal antibody can eliminate the sensitive antibody selectively,reduce the incidence of AR after kidney transplantation,improve the 1 year graft survival rate,and down-regulate the serum creatinine levels at 6 months and 12 months for kidney transplantation recipients.