Issitt Richard, Shetty Pooja, Crook Richard, Cross Nigel, Henwood Sophie, Broadhead Michael, Spencer Helen, Aurora Paul, Gupta Arun, Kallon Delordson, Fenton Matthew, Muthialu Nagarajan
Department of Perfusion, Great Ormond Street Hospital, London, UK.
Institute of Cardiovascular Science, University College London, London, UK.
Perfusion. 2023 Oct;38(7):1530-1533. doi: 10.1177/02676591221114958. Epub 2022 Jul 15.
Sensitised patients undergoing Human Leukocyte Antigen-incompatible transplantation are at increased risk of hyperacute rejection and may be predisposed to antibody-mediated rejection, chronic lung allograft dysfunction and higher mortality.
We present a case of primary lung transplantation in the setting of late identification of donor specific antibodies treated with intraoperative target plasma exchange. The patient was treated with fresh human plasma to a final volume of 1.5 times the patient's systemic circulation. From a pre-transplant mean fluorescence intensity of 5002, donor-specific antibodies were undetectable following plasma exchange on single antigen bead assay.
This method represents a potential desensitisation technique for use in the intraoperative period.
接受人类白细胞抗原不相合移植的致敏患者发生超急性排斥反应的风险增加，且可能易发生抗体介导的排斥反应、慢性肺移植功能障碍和更高的死亡率。
我们报告一例在晚期识别出供体特异性抗体的情况下进行的原发性肺移植病例，术中采用目标血浆置换治疗。患者接受新鲜人血浆治疗，最终体积为患者体循环的1.5倍。单抗原珠试验显示，血浆置换后供体特异性抗体从移植前的平均荧光强度5002降至检测不到。
该方法代表了一种术中潜在的脱敏技术。
