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[一例ABO血型不相容活体肾移植临床病例]

[A clinical case of ABO-incompatible living renal transplantation].

作者信息

Kawami H, Shiramizu T, Mori Y, Yayama T, Yonemura T, Oka N, Inokuchi K

机构信息

Department of Surgery, Saga Prefectural Hospital, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1990 Aug;91(8):1044-7.

PMID:2233659
Abstract

We successfully made ABO-incompatible renal transplantation, of which report is methodologically the first in Japan and probably the second in the world to our knowledge. Sixty year-old-female (mother) with B-blood type donated her right kidney to 36 years-old male (son) with O-blood type. Pretransplant removal of plasma isoagglutinin of the recipient through plasma exchange with albumin solution followed by hemodialysis with administration of fresh frozen B-type plasma effectively reduced the anti-BIgM-antibody titre of x256 to x8 and the anti-IgG-antibody titre of x512 to x16. Splenectomy was performed at the time of transplantation. On the 10th POD, the anti-B antibody titres were more decreased to IgM antibody x2 and IgG antibody x8. Patient is doing well without any sign of rejection as of 4 months postoperatively.

摘要

我们成功实施了ABO血型不相容的肾移植手术,据我们所知,从方法学角度而言,此报告在日本尚属首例,在世界范围内可能是第二例。一名60岁的B型血女性(母亲)将其右肾捐赠给了一名36岁的O型血男性(儿子)。术前通过用白蛋白溶液进行血浆置换,随后给予新鲜冷冻B型血浆进行血液透析,去除受者的血浆同种凝集素,有效地将抗B IgM抗体滴度从x256降至x8,抗IgG抗体滴度从x512降至x16。在移植时进行了脾切除术。术后第10天,抗B抗体滴度进一步下降,IgM抗体降至x2,IgG抗体降至x8。截至术后4个月,患者情况良好,无任何排斥迹象。

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