免疫性血小板减少症活体肾移植成功:病例报告。

Clinical transplantation and research Pub Date : 2024-06-30 Epub Date: 2024-04-15 DOI:10.4285/ctr.24.0002
Hsiao-Hui Yang, Ching-Chun Ho, Chia-Ling Lee, Yi-Feng Wu, Yen-Cheng Chen
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引用次数: 0

摘要

免疫性血小板减少症(ITP)是一种涉及自身抗体介导的血小板破坏的疾病,由于移植介导的自身免疫性血小板减少症(TMAT)是一种罕见但可能致命的并发症,因此从患有这种疾病的供体进行器官移植成为一个争论的话题。之前的报道描述了从已故肝脏捐献者身上移植ITP的病例,这些患者的血小板计数非常低,而且疾病对治疗基本无效。在此,我们介绍了首例由患有 ITP 的供体进行活体肾移植的病例,该供体接受了术前治疗,并同时进行了脾切除术,以降低自发性出血的长期风险。为确保手术的安全性,我们对围手术期的旋转血栓弹性测量参数和血小板计数进行了监测,使供体的血小板水平恢复正常。受者的肾功能恢复顺利,没有发生围手术期出血或 TMAT。我们的报告表明,从患有管理良好的 ITP 的供体进行肾移植是安全的,这种情况不应被视为捐献的禁忌症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Successful kidney transplantation from a live donor with immune thrombocytopenia: a case report.

Organ transplantation from donors with immune thrombocytopenia (ITP), a condition involving the autoantibody-mediated destruction of platelets, is a topic of debate due to the potential for transplantation-mediated autoimmune thrombocytopenia (TMAT), a rare but potentially fatal complication. Previous reports have described transplants from deceased liver donors with ITP who had very low platelet counts and disease largely refractory to treatment. Here, we present the first case of living kidney transplantation from a donor with ITP who underwent preoperative treatment, with concurrent splenectomy performed to reduce the long-term risk of spontaneous hemorrhage. To ensure the safety of the procedure, we monitored perioperative rotational thromboelastometry parameters and platelet counts, leading to the normalization of the donor's platelet levels. The recipient experienced an uneventful recovery of renal function without perioperative bleeding or the development of TMAT. Our report suggests that kidney transplantation from a donor with well-managed ITP is safe, and such a condition should not be considered a contraindication for donation.

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