Application of double filtration plasmapheresis in ABO﹣incompatible liver transplantation / 器官移植

ABSTRACT

Objective To observe the clinical efficacy and safety of double filtration plasmapheresis (DFPP)in eliminating blood group antibody in ABO﹣incompatible patients undergoing liver transplantation. Methods Eighteen recipients with ABO﹣incompatible liver transplantation in the General Hospital of Chinese People’s Armed Police from January 2012 to December 2014 were selected in the ABO﹣incompatibility group.The recipients with an antibody titer of anti﹣A or anti﹣B blood group >1∶16 were scheduled to undergo DFPP.Another 20 recipients eligible for blood transfusion were chosen into the control group.The changes in the antibody titer,blood biochemical parameters and the incidence of complications were observed in recipients with ABO﹣incompatible liver transplantation.The incidence of acute rejection and mortality rate between the ABO incompatibility group and control group were statistically compared. Results Among 18 patients,15 with an antibody titer of anti﹣A or anti﹣B blood group >1 ∶16 received DFPP.After DFPP,the mean antibody titer was significantly declined.Detection of blood biochemical parameters indicated that the level of fibrinogen was significantly decreased following DFPP (P =0.0001 ).Among 20 cases receiving DFPP,3 cases presented with hypotension,3 with hemorrhage,1 with nausea and vomiting,and 1 with coagulation in pipeline.All symptoms were alleviated after effective treatment.The incidence of acute rejection and mortality rate did not significantly differ between the ABO﹣incompatibility group and control group after DFPP (both P >0.05). Conclusions DFPP can safely and effectively reduce the level of blood group antibody,decrease the incidence of acute rejection after liver transplantation and enhance the success rate of liver transplantation.