Beneficial Effect of Plasma Exchange with Use of Albumin-Based Solution on Accelerated Acute Rejection after Renal Transplantation

概要

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We report, in this study, a successful case of plasma exchange (PE) using 5% albumin-contained lactate Ringer's solution for accelerated acute rejection. Living-related kidney transplantation was performed on a 29-year-old female with chronic renal failure. Direct cross-match in both T and B cells before transplantation was negative. On the sixth post-opcrative day. transplant renal function was remarkably deteriorated, anti-T cell antibody and anti-B cell antibody (wormB) showed positive in direct cross-match, and a decrease in renal blood flow was confirmed by radio isotope scan; accelerated acute rejection was clinically diagnosed. PE using albumin-based solution was applied four times combined with antilymphocyte globulin (ALG) treatment for rejection. The quantity of 1-time substitution, supplement liquid was 2 L. The data during PE including electrolyte baiance and coagulation system were shown to be within the normal range except for mild hypoproteinemia. Renal function recovered remarkably, and the number of positive cross-match cells decreased. PE using albumin-based solution was effective for treatment of accelarated acute rejection after renal transplantation. Infection and antigen senshization werc prevented, and cost-effectiveness was also proven.
日本アフェレシス学会の論文
1998-02-28