| 篇名 |
Plasmapheresis for Acute Humoral Rejection in Heart Transplant Patients |
| 作者 |
Shao-Jung Li, Nai-Kuan Chou, Yih-Sharng Chen, Wen-Je Ko, Shu-Hsun chu, Shoei-Shan Wang |
| 卷期/出版年月 |
36卷6期 (2003/12) |
| 頁次 |
260-267 |
| 摘要 |
Objective: We report our experience of treating acute humoral rejection with plasmapheresis and rescued immunosuppression in heart transplant recipients.
Method: Between March 1995 and October 2000, 5 heart transplant recipients received plasmapheresis for acute humoral rejection at our hospital. Acute humoral rejection was diagnosed by endomyocardial biopsy, characteristic echocardiographic findings, and clinical symptoms and signs. Endomyocardial biopsy revealed focal deposition of IgG, IgM, C3, C4 or HLA-DR Ag by immunofluorescence study (n=3) or interstitial edema only (n=2). These patients received daily plasmapheresis for 4 to 6 days in each treatment course. The third case received 3courses of plasmapheresis because of persistently deteriorated myocardial contractility. During the course of acute humoral rejection, two cases needed mechanical circulatory support in addition to catecholamine infusion.
Results: After plasmapheresis and concurrent rescue immunosuppression, all 5 patients could be weaned from catecholamine and mechanical circulatory support and cardiac function recovered well. No recurrence of humoral rejection was noted in the follow-up.
Conclusion: Plasmapheresis with concurrent rescue immunosuppression is an effective treatment for those heart transplantation patients who suffered from acute humoral rejection complicated by unstable hemodynamics. |
| 關鍵詞 |
heart transplantation, plasmapheresis, humoral rejection |
| 分類 |
Original Articles |
