期刊文献+

肾移植术后抗HLA抗体升高对移植肾功能的慢性损害作用 被引量:2

Renal allograft function impairment by posttransplunt unti-HLA antibodies
原文传递
导出
摘要 目的探讨肾移植术后抗HLA抗体升高对移植肾功能的慢性损害作用。方法采用免疫荧光液相芯片技术检测57例肾移植术后半年以上受者的抗HLA抗体水平,根据抗HLA抗体水平的不同,将受者分为抗HLA抗体(≥10%)阳性组和抗HLA抗体(〈10%)阴性组。再根据阳性组中抗HLA抗体类别的不同,将受者分为抗HLA—Ⅰ类抗体阳性、Ⅱ类抗体阴性(Ⅰ+Ⅱ-)组,抗HLA—Ⅰ类、Ⅱ类抗体均阳性(Ⅰ+Ⅱ+)组和抗HⅠ。A-Ⅰ类抗体阴性、Ⅱ类抗体阳性(Ⅰ-Ⅱ+)组。观察和比较各组受者的临床资料和血肌酐(Cr)水平,并进行统计学分析。结果57例受者中,抗HLA抗体阴性组41例(71.9%),阳性组16例(28.1%);阳性组中,Ⅰ+Ⅱ-组和Ⅰ+Ⅱ+组受者各3例-组10例。抗HⅠ。A抗体阴性组和阳性组受者的肾移植术后时间分别为(4.55±3.16)年和(6.64±3.66)年(P〈0.05),随着术后时间的延长,抗HLA抗体阳性者呈上升趋势。抗HLA抗体阴性组有13例(31.7%)血Cr异常,平均血Cr水平为(92.12±27.52)μmol/L;阳性组有13例(81.3%)血Cr异常,平均血cr水平为(191.81±119.95)ymol/L,其中又以Ⅰ+Ⅱ+组的受者血Cr水平最高,为(213.00±165.38)μmol/L,与抗HLA抗体阴性组比较,差异有统计学意义(P〈O.05)。结论抗HLA抗体升高是影响肾移植预后的重要标志物;尤其是抗HLA-Ⅱ类抗体升高对移植肾功能有慢性损害作用。 Objective To explore the impact of posttransplant anti-HLA antibodies on renal allograft function. Methods Fifty seven patients with renal aUografts for at least 6 months were detec- ted for the levels and specialties of anti HLA antibodies by Flow PRA beads. The patiems were divi- ded into positive and negative groups according to different levels of anti-HLA antibodies. The positive group could be divided into three groups: anti-HLA class Ⅰ± and class Ⅱ- ; anti-HLA class Ⅰ± and class Ⅱ± ; anti HLA class Ⅰ- and class Ⅱ±. Simultaneously, their serum creatinine levels and clinical data were analyzed statistically. Results HLA antibodies were found in 28. 1% (16/57) of the total pa- tients. Three cases were positive for anti-HLA class Ⅰ, 3 for both anti-HLA class Ⅰ and class Ⅱ antibodies, and 10 (or anti-HLA class Ⅱ. The survival time of renal transplant patients was (4. 55 ±3.16) and (6. 64 ± 3.66) years in anti-HLA antibodies negative and positive groups, respectively (P〉 0. 05). With the prolongation of time posttransplant, the positive rate of anti-HLA antibodies was in- creased. The levels of serum creatinine in 13 patients without anti-HLA antibodies were (92.12 ± 27. 52)/,mol/L, and those in 13 patients with anti-HLA antibodies were (191.81 ± 119. 95)/,mol/L. Ⅰn anti-HLA antibodies positive group, the levels of serum creatinine in Ⅰ+ Ⅱ- group were highest (213.00± 165.38μmol/L), and there was significant difference in comparison to anti-HLA antibodies group (P〈0. 05). Conclusions The increases in anti-HLA antibodies could be one of the important prognostic markers in renal transplant. The renal allograft function could be impaired by the increased anti-HLA class Ⅱ.
出处 《中华器官移植杂志》 CAS CSCD 北大核心 2008年第6期359-361,共3页 Chinese Journal of Organ Transplantation
基金 江苏省自然科学基金(BK2007056) 江苏省高校自然基金(07KJB3320107) 江苏省卫生厅重点人才基金(RC2007079) 苏州市基础设施项目(SZS0702) 苏州市中外国际合作项目(SWH0716)
关键词 肾移植 HLA抗原 移植免疫学 Kidney transplantation HI.A antigens Transplantation immunology
  • 相关文献

参考文献11

  • 1Tinckam KJ, Chandraker A. Mechanisms and role of HLA and non HLA alloantibodies. Clin J Am Soc Nephrol, 2006,1 (3) : 404-414.
  • 2Colvin RB. Antibody-mediated renal allograft rejection: diagnosis and pathogenesis. J Am Soc Nephrol, 2007, 18 (4) : 1046-1056.
  • 3Terasaki PI, Ozawa M. Predictive value of HLA antibodies and serum creatinine in chronic reiection: results of a 2-year prospective trial. Transplantation, 2005, 80 (9) : 1194-1197.
  • 4Lee PC, Terasaki PI, Takemoto SK, et al. All chronic rejection failures of kidney transplants were preceded by the devel opment of HLA antibodies. Transplantation, 2002, 74 (8): 1192-1194.
  • 5Cai J, Terasaki PI. Humoral theory of transplantation: mechanism, prevention, and treatment. Hum Immunol, 2005, 66 (4) :334-342.
  • 6Jindra PT, Zhang X, Mulder A, et al. Anti-HLA antibodies can induce endothelial cell survival or proliferation depending on their concentration. Transplantation, 2006, 82 Suppl 1: S33-35.
  • 7Kari JA, Donald AE, Vallance DT, et al. Physiology and biochemistry of endothelial function in children with chronic renal failure. Kidney Int, 1997, 52 (2): 468-472.
  • 8Campos EF, Tedesco-Silva H, Machado PC,, et al. Post- transplant anti-HLA class II antibodies as risk factor for late kidney allograft failure. Am J Transplant, 2006, 6 (10): 2316-2320.
  • 9Jin Y, Peter TJ, Gong K, et al. Anti-HLA class I antibodies activate endothelial cells and promote chronic rejection. Transplantation, 2005, 79 (3): 19 -21.
  • 10Mizutani K, Terasaki P, Rosen A, et al. Serial ten-year follow-up of HLA and MICA antibody production prior to kidney graft failure, Am J Transplant, 2005, 5 (9): 2265-2272.

同被引文献13

  • 1后平钦,李国良,唐绮,孙瑜,肖莉.PRA致敏患者抗体特异性及其动态观察[J].江西医学检验,2006,24(2):183-183. 被引量:1
  • 2陈建华,魏文宁,朱明光,邹萍.肾移植受者血清中抗供者特异性抗体检测及预测排斥反应的意义[J].临床检验杂志,2007,25(2):99-100. 被引量:3
  • 3Van Kampen CA ,Roelen DL ,Versteeg VDM ,et al. Ac- tivated HLA class I reactive cytotoxic T lymphocytes associated with a positive historical crossmatch predict early graft failure [J]. Transplantation, 2002, 74 (8) : 1114-1119.
  • 4Dilioglou S ,Cruse JM ,Lewis RS ,et al. High panel reac- tive antibody against cross-reactive group antigens ,as a contraindication to renal allotransplantation [J]. Exp Mol Patho1,2001,71(1) : 73-78.
  • 5Lee PC,Terasaki PI,Takemoto SK,et al. All chronic rejection failures of kidney transplants were preceded by the development of HLA antibodies[J]. Transplan- tation, 2002,74 (8) : 1192-1194.
  • 6Cai J,Terasaki PI. Humoral theory of transplantation: mechanism, prevention, and treatment [J]. Hum Im- munol, 2005,66 (4) : 334-342.
  • 7Karl JA, Donald AE, Vallance DT, et al. Physiology and biochemistry of endothelial function in children with chronic renal failure EJ 7. Kidney Int, 1997,52 (2) : 468-472.
  • 8Colvin RB. Antibody-mediated renal allograft rejection : diagnosis and pathogenesis [J] . J Am Soc Nephrol, 2007,18 (4) : 1046-1056.
  • 9Campos EF,Tedesco-Silva H,Machado PG,et al. Post- transplant anti-HLA class Ⅱ antibodies as risk factor for late kidney allograft failure[J]. Am J Transplant, 2006,6(10) :2316-2320.
  • 10Jin Y,Peter TJ,Gong K,et al. Anti-HLA class I anti- bodies activate endothelial cells and promote chronic rejection[J]. Transplantation, 2005,79 (3) : 19-21.

引证文献2

二级引证文献2

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部