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【文摘发布】ABO血型不合的肾移植实施方案－－
author：Tyden, Gunnar ; Donauer, Johannes 2; Wadstrom, Jonas 3; Kumlien, Gunilla 1; Wilpert, Jochen 2; Nilsson, Thomas 3; Genberg, Helena 1; Pisarski, Przemislaw 2; Tufveson, Gunnar
source：Transplantation. 83(9):1153-1155, May 15, 2007.
abstract：Background. A new protocol for ABO-incompatible kidney transplantation has recently been introduced. We report here on the joint experience of the implementation in Stockholm and Uppsala, Sweden and Freiburg, Germany.
Methods. The new protocol utilizes antigen-specific immunoadsorption to remove existing ABO-antibodies, rituximab, and intravenous immunoglobulin to prevent the rebound of antibodies, and conventional tacrolimus, mycophenolate-mofetil, and prednisolone immunosuppression. Sixty consecutive ABO-incompatible kidney transplantations were included in the study. The outcome is compared with the results of 274 ABO-compatible live donor transplantations performed during the same period.
Results. Two of the ABO-incompatible grafts have been lost (non-compliance and death with functioning graft). All the remaining 58 grafts had good renal function at a follow-up of up to 61 months. We did not observe any late rebound of antibodies and there were no humoral rejections. Graft survival was 97% for the ABO-incompatible compared with 95% for the ABO-compatible. Patient survival was 98% in both groups. There was a significant variation in preoperative A/B-antibody titer between the centers, with a median 1:8 in Uppsala, median 1:32 in Stockholm and median 1:128 in Freiburg. More preoperative antibody adsorptions were therefore needed in Freiburg than in Stockholm and Uppsala.
Conclusions. The new protocol was easily implemented and there were no graft losses that could be related to ABO-incompatibility. A significant inter-institutional variation in the measurement of anti-AB-antibodies was found, having a substantial impact on the number of immunoadsorptions and consequently on the total cost for the procedure. A standardized fluorescence-activated cell sorting technique for antibody quantification is much needed. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 title：Implementation of a Protocol for ABO-Incompatible Kidney Transplantation - A Three-Center Experience With 60 Consecutive Transplantations.
标题：ABO血型不合的肾移植实施方案――3个中心连续60例的移植经验
author：Tyden, Gunnar ; Donauer, Johannes 2; Wadstrom, Jonas 3; Kumlien, Gunilla 1; Wilpert, Jochen 2; Nilsson, Thomas 3; Genberg, Helena 1; Pisarski, Przemislaw 2; Tufveson, Gunnar
作者：Tyden, Gunnar ; Donauer, Johannes 2; Wadstrom, Jonas 3; Kumlien, Gunilla 1; Wilpert, Jochen 2; Nilsson, Thomas 3; Genberg, Helena 1; Pisarski, Przemislaw 2; Tufveson, Gunna
source：Transplantation. 83(9):1153-1155, May 15, 2007.
源自：《器官移植》。2007年5月15日，83(9)：1153-1155。
abstract：Background. A new protocol for ABO-incompatible kidney transplantation has recently been introduced. We report here on the joint experience of the implementation in Stockholm and Uppsala, Sweden and Freiburg, Germany.
摘要：背景. 一项关于ABO血型不合的肾移植的新方案近来被推出。我们的报告是据在瑞典的斯德哥尔摩和乌普撒拉以及德国的浮雷堡实施经验得出。
Methods. The new protocol utilizes antigen-specific immunoadsorption to remove existing ABO-antibodies, rituximab, and intravenous immunoglobulin to prevent the rebound of antibodies, and conventional tacrolimus, mycophenolate-mofetil, and prednisolone immunosuppression. Sixty consecutive ABO-incompatible kidney transplantations were included in the study. The outcome is compared with the results of 274 ABO-compatible live donor transplantations performed during the same period.
方法：新方案利用抗原特异性免疫吸附，清除现有的ABO血型抗体，利妥昔单抗与静脉注射免疫球蛋白防止抗体复原，以及常规的他克莫司，麦考酚酸莫酯和泼尼松龙免疫抑制剂。在该研究中有60例相连的ABO血型不合肾移植患者。结果与同时期274例 ABO血型适合的活体移植手术做对比。
Results. Two of the ABO-incompatible grafts have been lost (non-compliance and death with functioning graft). All the remaining 58 grafts had good renal function at a follow-up of up to 61 months. We did not observe any late rebound of antibodies and there were no humoral rejections. Graft survival was 97% for the ABO-incompatible compared with 95% for the ABO-compatible. Patient survival was 98% in both groups. There was a significant variation in preoperative A/B-antibody titer between the centers, with a median 1:8 in Uppsala, median 1:32 in Stockholm and median 1:128 in Freiburg. More preoperative antibody adsorptions were therefore needed in Freiburg than in Stockholm and Uppsala.
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作者:admin@医学,生命科学 2011-02-27 05:11
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