输血诱导的无反应性：皮肤试验作为移植前输血的一个指标。

Transfusion-induced anergy: skin test as an index for pretransplant transfusions.

作者信息

Valderrábano F, Anaya F, Pérez-García R, Olivas E, Vasconez F, Jofre R

出版信息

Proc Eur Dial Transplant Assoc. 1983;20:338-48.

Abstract

Cell-mediated immunity in vivo was studied by delayed cutaneous hypersensitivity (DCH) to seven antigens in 156 chronic haemodialysis (HD) patients, using a disposable multipuncture device. Anergy was found in 46.8 per cent of patients, and a positive correlation was seen between anergy and female sex, time on HD, glomerulonephritis as primary renal disease, younger age and previous blood transfusions (BT). The effect of BT on DCH was studied prospectively in 29 responsive patients. A significant decrease in DCH response was seen. The transfusion-induced anergy remained for a variable time. The pretransplant BT policy suggested by our data would be to periodically undertake skin tests and to transfuse only responsive patients, thereby avoiding the adverse effects of multiple BT.

摘要

采用一次性多点穿刺装置，通过对156例慢性血液透析（HD）患者进行针对七种抗原的迟发型皮肤超敏反应（DCH），研究了体内的细胞介导免疫。发现46.8%的患者存在无反应性，且无反应性与女性性别、血液透析时间、原发性肾脏疾病为肾小球肾炎、年龄较小以及既往输血（BT）之间呈正相关。对29例有反应性的患者前瞻性地研究了输血对DCH的影响。观察到DCH反应显著降低。输血诱导的无反应性持续时间不一。我们的数据所建议的移植前输血策略是定期进行皮肤试验，仅对有反应性的患者输血，从而避免多次输血的不良反应。