血浆置换预防ABO血型主要不合骨髓输注溶血反应的疗效

Plasma exchange for prevention of acute hemolysis in major ABO-incompatible bone marrow transplantation

目的 :观察血浆置换预防ABO血型主要不合骨髓移植时骨髓输注溶血反应的效果。方法 :采用血浆置换去除受者体内凝集素的方法预防 2例ABO血型主要不合骨髓移植急性溶血反应。置换液主要采用供体血型血浆 ,例 1置换血浆 42 2 0ml,例 2置换血浆 4339ml。结果 :血浆置换后 ,2例患者抗体滴度 (IgM、IgG)均在 1∶16以下 ,输注血型主要不合骨髓时均未发生急性溶血反应 ,亦未出现迟发性溶血反应 ;2例患者均植入成功 ,其中1例发生Ⅰ度急性移植物抗宿主病。结论 :血浆置换可有效预防ABO血型主要不合骨髓移植时溶血反应的发生。

Objective:To evaluate the effect of plasma exchange for prevention of acute hemolysis in major ABO incompatible bone marrow transplantation.Method: Plasma exchanges were done for two patients transplanted with major ABO incompatible unrelated donor to prevent acute hemolysis. The plasma from the recipients was removed and replaced with the donor blood type plasma. The total volume of 4200ml plasma was removed for case one and 4390ml for case two. Result: The isohemagglutinin titers of two patients after plasma exchange were below 1:16 and the acute hemolysis didn't occur .All two patients were engrafted and the case 2 had the acute graft versus host disease(grade one).Conclusion: Plasma exchange can effectively prevent acute hemolysis in patients of bone marrow transplantation with major ABO incompatible unrelated donors.