Lopatkin N A, Kozlov V A, Iarmolinskiĭ I S, Danilov A P, Khalatov A S
Urol Nefrol (Mosk). 1989 Jul-Aug(4):3-7.
To define the efficacy of plasmapheresis performed as part of combined treatment for steroid-resistant patterns of acute rejection of a renal transplant, the results of the treatment were analysed in 11 patients. The analysis also involved the results of plasmapheresis treatment of 3 patients with terminal renal failure complicated with septic conditions and 1 patient with stenosed artery of the transplanted kidney and irreversible arterial hypertension. Plasmapheresis was used in various terms of rejection after a 3-4-day prednisolone pulsatile therapy. The effect of the procedure was recorded in 7 out of 13 patients, i. e. in 50 per cent of those treated. The necessity of applying early plasmapheresis (immediately after methylprednisolone pulsatile therapy in case of its failure) was demonstrated as were the methods of intensive plasmapheresis performance (daily within 4-5 days). The technique permitted to eliminate septic conditions before and after the period of transplantation, to decrease blood pressure in the patients with stenosed arteries of transplanted kidney. The authors considered the mechanism of the curative effect of plasmapheresis in the patients with acute rejection and the criteria for its efficiency.
为确定血浆置换作为肾移植急性排斥反应激素抵抗型联合治疗一部分的疗效，对11例患者的治疗结果进行了分析。分析还涉及3例终末期肾衰竭合并脓毒症患者及1例移植肾动脉狭窄伴不可逆性动脉高血压患者的血浆置换治疗结果。在进行3 - 4天的泼尼松龙冲击治疗后，在不同排斥阶段使用了血浆置换。13例患者中有7例记录到该治疗方法有效，即50%的治疗患者有效。证明了早期应用血浆置换（在甲泼尼龙冲击治疗失败后立即进行）的必要性以及强化血浆置换的实施方法（4 - 5天内每日进行）。该技术能够在移植前后消除脓毒症情况，降低移植肾动脉狭窄患者的血压。作者探讨了血浆置换对急性排斥反应患者的治疗作用机制及其疗效标准。
