双重滤过血浆置换和血浆置换对ABO血型不容肾移植受者术前血型抗体去除效果单中心对比研究*

doi:10.3969/j.issn.1671-2587.2024.03.005

临床输血与检验 ›› 2024, Vol. 26 ›› Issue (3): 325-331.DOI: 10.3969/j.issn.1671-2587.2024.03.005

双重滤过血浆置换和血浆置换对ABO血型不容肾移植受者术前血型抗体去除效果单中心对比研究^*

杨昊¹, 董树岭², 杨乾坤², 韩月³, 王书亚², 靳慧芳², 郑露², 唐悦¹

¹郑州大学基础医学院,郑州 450001;
²郑州大学第一附属医院输血科,郑州 450052;
³阜外华中心血管病医院输血科,郑州 451460

收稿日期:2024-03-05 出版日期:2024-06-20 发布日期:2024-06-24
通讯作者: 唐悦,主要从事肿瘤免疫方面的研究,（E-mail）tangyue@zzu.edu.cn。
作者简介:杨昊,主要从事输血相容性检测、治疗性血细胞成分单采等方面的研究,（E-mail）yhyangh8@126.com。
基金资助:
*河南省医学科技攻关计划项目（No.2018020026）资助

Effect of Double Filtration Plasmapheresis and Plasma Exchange on Blood Type Antibody Removal in ABO-incompatible Kidney Transplantation Recipients: A Single Center Comparative Analysis

YANG Hao¹, DONG Shuling², YANG Qiankun², HAN Yue³, WANG Shuya², JIN Huifang², ZHENG Lu², TANG Yue¹

¹School of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450001;
²Department of Blood Transfusion,the First Affiliated Hospital of Zhengzhou University 450052;
³Department of Blood Transfusion,Fuwai Central China Cardiovascular Hospital 451460

Received:2024-03-05 Online:2024-06-20 Published:2024-06-24

摘要/Abstract

摘要： 目的对比研究双重滤过血浆置换（double filtration plasmapheresis, DFPP）和血浆置换（plasma exchange, PE）对ABO血型不相容肾移植（ABO incompatible kidney transplantation, ABOi-KT）术前血型抗体去除效果。方法收集郑州大学第一附属医院2021年2月—2023年12月ABOi-KT术前36例单纯DFPP和27例单纯PE受者的临床资料以及每次治疗前后抗体效价,并对其进行差异化分析。结果 DFPP组和PE组分别进行了98次和82次治疗;DFPP和PE治疗后血型抗体效价均较治疗前显著降低（P<0.05）;DFPP和PE均显示出对高效价抗体较好的去除效果,DFPP对效价≥32组IgG抗-A、IgG抗-B和IgM抗-B抗体去除效果优于效价≤16组（P<0.05）,PE治疗对效价≥32组IgM抗-A和IgM抗-B抗体去除效果优于效价≤16组（P<0.05）;整体上,DFPP和PE对不同类型抗体去除效果均无显著差异,但当效价≥32时,DFPP和PE均显示出对IgM类抗体较好的去除效果,PE更为明显;PE对抗-A抗体去除效果优于DFPP,这种优势主要表现为,当效价≤16时,PE较DFPP表现出对IgG抗-A抗体较好的去除效果（P<0.05）,当效价≥32时,PE较DFPP表现出对IgM抗-A抗体较好的去除效果（P<0.05）,两种方法对其他血型抗体的去除效果差异无统计学意义（P>0.05）。结论 DFPP和PE均可显著降低血型抗体效价,两种方法均对高效价抗体去除效果较好。除PE对低效价IgG抗-A和高效价IgM抗-A抗体去除效果较DFPP好外,两种方法对其他血型抗体去除效果无显著差异。

关键词: 双重滤过血浆置换, 血浆置换, ABO血型不相容, 肾移植, 抗体效价

Abstract: Objective To compare the effect of double filtration plasmapheresis (DFPP) and plasma exchange (PE) on blood type antibody removal before ABO-incompatible kidney transplantation (ABOi-KT). Method Clinical data and antibody titers before and after each treatment of 36 recipients treated with DFPP and 27 recipients treated with PE before ABOi-KT from February 2021 to December 2023 in the First Affiliated Hospital of Zhengzhou University were collected and analysed. Results 98 and 82 times of treatment were performed in DFPP and PE group, respectively. The titers of blood type antibodies after DFPP and PE treatment were significantly lower than those before treatment (P<0.05). Both DFPP and PE showed good removal effect on high titer antibodies, and the removal effect of DFPP on IgG anti-A, IgG anti-B and IgM anti-B antibodies in group of titer ≥32 was better than that in group of titer ≤16 (P<0.05). The removal effect of PE on IgM anti-A and IgM anti-B antibodies in group of titer ≥32 was better than that in group of titer ≤16 (P<0.05). Overall, DFPP and PE showed no significant difference in the removal effect on different types of antibodies. However, both DFPP and PE showed a better removal effect on IgM antibodies in group of titer ≥32 compared with group of titer ≤16 (P<0.05), and the effect of PE was more obvious. The removal effect on anti-A antibodies in PE group was better than that in DFPP group. This advantage was mainly manifested as follows: PE had a better removal effect on IgG anti-A antibody than DFPP in group of titer ≤16 (P<0.05); PE had a better removal effect on IgM anti-A antibody than DFPP in group of titer ≥32 (P<0.05). There was no significant difference between the two methods in the removal effect on the other blood group antibodies (P>0.05). Conclusion Both DFPP and PE can significantly reduce the titer of blood type antibodies, and the two methods have a better removal effect on high titer antibodies. There was no significant difference between the two methods in the removal of antibodies of other blood groups, except that the removal efficiency of low titer IgG anti-A and high titer IgM anti-A antibodies by PE was better than that by DFPP.

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

中图分类号:

R457.2

杨昊, 董树岭, 杨乾坤, 韩月, 王书亚, 靳慧芳, 郑露, 唐悦. 双重滤过血浆置换和血浆置换对ABO血型不容肾移植受者术前血型抗体去除效果单中心对比研究^*[J]. 临床输血与检验, 2024, 26(3): 325-331.

YANG Hao, DONG Shuling, YANG Qiankun, HAN Yue, WANG Shuya, JIN Huifang, ZHENG Lu, TANG Yue. Effect of Double Filtration Plasmapheresis and Plasma Exchange on Blood Type Antibody Removal in ABO-incompatible Kidney Transplantation Recipients: A Single Center Comparative Analysis[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2024, 26(3): 325-331.

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双重滤过血浆置换和血浆置换对ABO血型不容肾移植受者术前血型抗体去除效果单中心对比研究^*

Effect of Double Filtration Plasmapheresis and Plasma Exchange on Blood Type Antibody Removal in ABO-incompatible Kidney Transplantation Recipients: A Single Center Comparative Analysis

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