成功抢救2例高龄胰肾联合移植患者严重PRCA并发症

Successful rescue of pure red cell aplasia in two aged patients with undergoing pancrease kindey transplantation

目的 探讨高龄胰肾联合移植病人免疫抑制低下与发生纯红细胞再障(PRCA)的关系。方法 1998年12月,5例胰肾移植患者中2例并发PRCA及自身免疫溶血性贫血,监测微小病毒B_(19),T_4/T_8比值及骨髓象。采用调整免疫抑制剂、抗病毒、输注红细胞等综合疗法。结果 2例PRCA患者分别于2周、3周骨髓象恢复正常,并观察1年以上无复发。结论 高龄、免疫力低下、微小病毒B_(19)感染、免疫抑制药物易诱发PRCA,临床综合治疗是有效措施。

Objective To evaluate the inoact of low immune function and the pure red cell aplasia (PRCA) in patients with simultaneous pancreas-kidney transplantation. Methods The peripheral cell subsets, parvovirus B19 and bone marrow sample were detected. Antivirus, decreasing immunosuppressant and transfusing pure red cell were performed in 2 cases in Dec 1998. Results 2 patients with PRCA recovered in 2 weeks and 3 weeks respectively and none of them was recurrent. Conclusion PRCA may be induced in the old patient with suppressed immune function, parvovirus B19 infection and immunosuppressant. Treating PRCA with combined therapy is efficient.