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Renal transplantation in highly sensitized patients

袁小鹏, Wei Gao, Li Jie, 姜松, 焦伟华, 郭在柱, Jian‐Hua Xu

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Abstract

目的探讨高度致敏肾移植受者的组织配型和抗排斥治疗方案.方法回顾性分析45例高度致敏肾移植受者的HLA抗体、HLA配型和肾移植后抗排斥反应治疗效果.结果肾移植术后发生超急性排斥反应2例(4.4%),急性排斥反应9例(20.9%),经激素、抗胸腺细胞球蛋白、血浆置换等治疗后均逆转.人/肾1年存活率分别为95.6%/91.1%.结论避开相应抗体的良好HLA配型,是高度致敏受者肾移植成功的关键.术后采用抗胸腺细胞球蛋白短程诱导、并用他克莫司、霉酚酸酯治疗,能减少急性排斥的发生率,提高移植物的存活率.

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目的探讨高度致敏肾移植受者的组织配型和抗排斥治疗方案.方法回顾性分析45例高度致敏肾移植受者的HLA抗体、HLA配型和肾移植后抗排斥反应治疗效果.结果肾移植术后发生超急性排斥反应2例(4.4%),急性排斥反应9例(20.9%),经激素、抗胸腺细胞球蛋白、血浆置换等治疗后均逆转.人/肾1年存活率分别为95.6%/91.1%.结论避开相应抗体的良好HLA配型,是高度致敏受者肾移植成功的关键.术后采用抗胸腺细胞球蛋白短程诱导、并用他克莫司、霉酚酸酯治疗,能减少急性排斥的发生率,提高移植物的存活率.

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Available abstract

目的探讨高度致敏肾移植受者的组织配型和抗排斥治疗方案.方法回顾性分析45例高度致敏肾移植受者的HLA抗体、HLA配型和肾移植后抗排斥反应治疗效果.结果肾移植术后发生超急性排斥反应2例(4.4%),急性排斥反应9例(20.9%),经激素、抗胸腺细胞球蛋白、血浆置换等治疗后均逆转.人/肾1年存活率分别为95.6%/91.1%.结论避开相应抗体的良好HLA配型,是高度致敏受者肾移植成功的关键.术后采用抗胸腺细胞球蛋白短程诱导、并用他克莫司、霉酚酸酯治疗,能减少急性排斥的发生率,提高移植物的存活率.

Key concepts: Transplantation, Medicine, Kidney transplantation, Intensive care medicine, Internal medicine

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