Kazimirov V G, Perlin D V, Shcherbakova E O, Prokopenko E I, Nesterenko I V
Anesteziol Reanimatol. 1998 Nov-Dec(6):62-5.
For many years the treatment of steroid-resistant rejection (SSR) remains a common problem od renal transplantation. We used plasmapheresis (PPH) in the treatment of SRR in 29 renal transplant recipients. All patients had progressive deterioration of renal function and compatible biopsy histology. The first group (15 patients) was administered PPH with methylprednisolone (MP). The second group (14 patients) was treated by intravenous MP. There was no significant difference in the time of beginning and severity of rejection. In the PPH group the results were better: a significant increase in SSR reversion was attained (73.3%) in comparison with the control (42.8%), the number of grafts lost during the first year was less (26.7 versus 57.2%). Better results were observed in patients with high levels of serum anti-HLA antibodies. Their transplants functioned well during 12 months after SSR. Hence, PPH can be used in patients with SSR with high levels of anti-HLA antibodies.
多年来，类固醇抵抗性排斥反应（SSR）的治疗一直是肾移植中的常见问题。我们对29例肾移植受者采用血浆置换术（PPH）治疗SRR。所有患者均出现肾功能进行性恶化且活检组织学表现相符。第一组（15例患者）接受PPH联合甲泼尼龙（MP）治疗。第二组（14例患者）采用静脉注射MP治疗。排斥反应开始时间和严重程度无显著差异。PPH组效果更佳：与对照组（42.8%）相比，SSR逆转率显著提高（73.3%），第一年移植肾丢失数量更少（26.7%对57.2%）。血清抗HLA抗体水平高的患者效果更佳。他们的移植肾在SSR后12个月内功能良好。因此，PPH可用于血清抗HLA抗体水平高的SSR患者。
