淋巴细胞群体反应性抗体检测在肾移植中的应用

Lymphocytepanelreactiveantibody(PRA)andkidneytransplantation

自１９９２年１０月～１９９５年１２月对２５２例等待肾移植患者进行淋巴细胞群体反应性抗体（ＰＲＡ）检测，其中３２例患者ＰＲＡ阳性，占１２．７％。２８例患者给予血浆置换２～５次后行肾移植术，术后全部患者均应用甲基泼尼松龙、ＡＴＧ（ＡＬＧ）或ＯＫＴ３治疗。结果：２例发生超急性排斥反应，１例加速排斥反应，均摘除移植肾；３个月内出现急性排斥反应２１例（６５．６％），１４例逆转（６６．７％），５例摘除移植肾恢复血透（２３．８％），２例因肺部严重感染死亡。就ＰＲＡ阳性的原因，ＰＲＡ与肾移植的关系。

FromOct.1992toDec.1995,PRAwasdetectedin252patientspriortokidneytrans-plantationandhasbeenpositivein32(12.7%).Plasmaexchange2～5timeswerecarriedoutfor28ofthe32beforetransplantatiom.Methylprednisolone,antilymphocyteglobulin(antithymocyteglobulin)orOKT3wereinstitutedaftertransplantationinal.Hyperacuterejectionoccurredin2recipientsandac-celeratedrejectioninanother,resultedingraftnephrectomyinalthe3.Within3monthsaftertrans-plantation,episodesofacuterejectionhavebeenobservedin21(65.6%)ofthe32.14(66.7%)ofthe21havebeensuccessfulyreversedwhilegraftnephrectomywasundertakenin5(23.8%).Theother2diedofseriouspneumonia.TheoccurrenceofPRAanditsrelationtokidneytransplantationwerediscussed.