Mourad G, Chong G, Cristol J P, Lorho R, Ramounau-Pigot A, Seignalet J
Service de Néphrologie, Hôpital Lapeyronie, Montpellier.
Nephrologie. 1993;14(2):91-4.
The use of erythropoietin (Epo) in chronic renal failure patients improves anemia and avoids iterative transfusions. As a consequence, a significant decrease of anti-HLA antibodies might be observed. From 31.12.1985 to 30.07.1991, among the 61 highly sensitized patients (pts) waiting for renal transplantation at our institution, 23 (7 men, 16 women, mean age 43.3 +/- 2.3 years) were treated with Epo during 21.4 +/- 1.7 months. After introduction of Epo, the mean number of transfusions significantly decreased from 35 +/- 8 to 0.5 +/- 0.4 (p < 0.0001) and the Panel Reactive Antibodies decreased from 88.1 +/- 1.7 to 18.8 +/- 5.6% (p < 0.0001). HLA antibodies totally disappeared in 12 patients, decreased more than 30% in 9 patients and remained stable in the 3 others. Renal transplantation was performed in 9 patients; 4 with a negative cross-match in both historical and current sera and 5 with a negative current cross-match but with a positive historical cross-match. 6/9 patients are doing well with a good graft function; 2 patients returned to hemodialysis for rejection and 1 patient died with a functioning kidney. Since Epo permits the transfusion withdrawal, its introduction in chronic renal failure treatment suppresses both the main factor of immunisation and one of the most important mechanisms of persistence of antibodies.
在慢性肾衰竭患者中使用促红细胞生成素（Epo）可改善贫血并避免反复输血。因此，可能会观察到抗HLA抗体显著减少。从1985年12月31日至1991年7月30日，在我们机构等待肾移植的61例高度致敏患者中，23例（7例男性，16例女性，平均年龄43.3±2.3岁）在21.4±1.7个月期间接受了Epo治疗。引入Epo后，输血的平均次数从35±8显著降至0.5±0.4（p<0.0001），群体反应性抗体从88.1±1.7降至18.8±5.6%（p<0.0001）。12例患者的HLA抗体完全消失，9例患者的抗体减少超过30%，另外3例患者的抗体保持稳定。9例患者接受了肾移植；4例患者既往和当前血清交叉配型均为阴性，5例患者当前交叉配型为阴性但既往交叉配型为阳性。9例患者中有6例情况良好，移植肾功能良好；2例患者因排斥反应恢复血液透析，1例患者肾功能正常但死亡。由于Epo允许停止输血，因此将其引入慢性肾衰竭治疗中可抑制免疫的主要因素以及抗体持续存在的最重要机制之一。
