两种血细胞分离机在跨血型肾移植中降低血型抗体滴度的效果比较

A Comparison of Plasma Exchange Performance between Two Blood Cell Separators

目的对比分析两种血细胞分离机在跨血型肾移植中降低血型抗体滴度方面的效果。方法利用CS-3000和COM.TEC血细胞分离机对2015年1月～2017年11月23例ABO血型不合肾移植受者行血浆置换治疗。结果使血型抗体滴度下降1倍,CS-3000组需置换出(1.3±0.5)个血浆容量,而COM.TEC组需置换出(0.9±0.2)个血浆容量。CS-3000组处理1个血浆容量所需时间为(95.2±10.4)min,COM.TEC组处理1个血浆容量所需时间为(75.0±11.2)min(P<0.001)。CS-3000组血浆去除效率为(39.7±4.9)%,而COM.TEC组血浆去除效率为(48.2±3.7)%(P<0.001)。与血浆置换前的血液成分相比,CS-3000组置换后患者血小板明显下降,平均下降25.42%,而COM.TEC组置换后患者血小板下降率为12.56%。结论与CS-3000血细胞分离机比较,COM.TEC血细胞分离机治疗性血浆置换有更高的血浆去除效率,处理1个全血浆容量所需时间更短,并且损失的血小板更少。相比之下COM.TEC比CS-3000血细胞分离机更适用于初始抗血型抗体效价较高且血小板较低的肾移植受者。

Objective To compare the efficacy of two blood cell separator in reduction of blood group antibody titers in renal transplants with incompatibility of blood groups. Methods Plasma exchange was performed on 23 patients with ABO incompatible renal transplant recipients between 2015 and 2017 by using the CS-3000 and COM.TEC blood cell separators. Results CS-3000 gave rise to the replace of 1.3±0.5 plasma volume and COM.TEC resulted in the replace 0.9±0.2 plasma volume for a half reduction of the antibody titers. The procedure time to exchange one plasma volume was 95.2±10.4 min with the CS-3000 and 7 5±11.2 min with the COM.TEC（P〈0.001）. The plasma removal efficiency（PRE） was39.7±4.9% with the CS-3000 and 48.2±3.7% with the COM.TEC（P〈0.001）. In comparison with the blood components before plasma exchange,the platelet counts of patients with the CS-3000 blood cell separator replacement obviously decreased by an average of 25.42% while those of patients with the COM.TEC reduced by 12.56%. Conclusion Compared with the CS-3000,the COM.TEC might improve PRE and have short procedure time and slight losses of platelet counts for exchange of one plasma volume. Additionally,the COM.TEC is suitable for kidney transplant recipients with high initial antibody titers and low number of platelets.