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本文总结9例接受相同血型尸体肾移植患者,术前血清淋巴细胞毒抗体阴性,术后发生加速型排异反应,经病理检查证实。加速型排异反应属不可逆性体液排异反应,主要病理改变为肾小血管急性炎症和纤维素样坏死,常伴血栓形成、出血和梗死灶,在临床上表现为排异反应时间早、程度严重,常在1～2周内发生移植肾功能衰竭,对大剂量肾上腺醣皮质类固醇治疗无效。及时诊断,早期摘除移植肾,可避免盲目免疫抑制剂治疗招致严重不良后果。并就如何诊断和预防此型排异反应作了讨论。
This article summarizes the 9 cases of patients receiving the same cadaver kidney transplantation, preoperative serum lymphocyte antibody negative, accelerated rejection occurred after the operation, confirmed by pathological examination. Accelerated rejection is an irreversible humoral rejection, the main pathological changes of acute renal microvascular inflammation and fibrillary necrosis, often accompanied by thrombosis, bleeding and infarction, the clinical manifestations of rejection reaction early, the extent of Serious, often occurs within 1 to 2 weeks of renal failure, high-dose glucocorticoid therapy is invalid. Timely diagnosis, early removal of kidney transplant, blind immunosuppressive agents can be avoided to cause serious adverse consequences. And how to diagnose and prevent this type of rejection reaction was discussed.