标准HLA-A、B、DR配型与氨基酸残基配型在肾移植术后早期急性排斥反应中的差异

The early rejection difference by standard HLA-A、B、DR matching or amino acid residues matching in kidney transplantation

目的 研究标准HLA -A、B、DR配型和氨基酸残基配型与肾移植术后早期急性排斥反应中的差异。方法 将 14 47例次肾移植受者 ,按HLA误配率 (MM )对标准配型和氨基酸残基配型 ,分别进行分组 ,统计各组术后 1～ 2个月内 ,急性排斥反应的发生率。结果 标准HLA配型 6误配组 ,术后早期急性排斥反应发生率为 2 1 .6% ;5误配组为 2 8. 9% ;4误配组为 19 .1% ;3误配组为 16. 5 % ;2误配组为 16 .3 % ;1和 0误配组未见术后早期急性排斥反应发生。而氨基酸残基配型 6误配组 ,术后早期急性排斥反应发生率为 2 8 .6% ;5误配组为 2 0 . 2 % ;4误配组为2 3 . 6% ;3误配组为 2 0 . 2 % ;2误配组为 2 0 . 4% ;1误配组为 19% ;0误配组为 16%。结论 标准HLA -A、B、DR配型比氨基酸残基配型在肾移植术后早期急性排斥反应中的作用更为明显。

Objective To study the difference of the early rejection by standard HLA-A?B?DR matching or amino acid residues matching in kidney transplantation. Methods The 1447 recipients undergoing kidney transplantation were randomly grouped in terms of the HLA mismatching frequency (MM)by standard HLA-A?B?DR matching or amino acid residues matching.The incidence of early rejection one month after operation was analyzed.Results The incidence of postoperative acute rejection was 21.6%;28.9%;19.1%;16.5%;16.3% in recipients with 6MM,5MM,4MM,3MM and 2MM respectively by standard HLA-A,B,DR matching.Postoperative acute rejection was not observed in 1MM and 0MM.The incidence of postoperative acute rejection was 28.6%;20.2%;23.6%;20.2%;20.4%;19% and 16% in recipients with 6MM,5MM,4MM,3MM,2MM,1MM and 0MM respectively by amino acid residues matching. Conclusion Our results show that standard HLA-A?B?DR matching is more sensitive than amino acid residues matching for the indication of early rejection in kidney transplantation.