群体反应性抗体检测在肾移植中的应用

PANEL REACTIVE ANTIBODY(PRA):A IMPORTANT CROSSMATCH METHOD IN KIDNEY TRANSPLANTATION

目的：建立群体反应性抗体（ＰＲＡ）的检测方法，分析术前ＰＲＡ检测在预测术后早期发生急性排斥反应中的价值；方法：以６２名健康成人外周血淋巴细胞作为群体淋巴细胞来源，依据补体依赖微量淋巴毒方法建立ＰＲＡ的检测方法。研究对象为１９９４年６月至１９９７年２月在我院行肾移植术的１２０例患者。结果：对１９９４年６月至１９９６年７月９８例患者的回顾性研究结果表明，随着ＰＲＡ水平的升高，术后一月内急性排斥的危险性也增高，７２％发生急性排斥反应的患者术前ＰＲＡ水平高于２０％；对１９９６年７月后患者的前瞻性研究结果表明，２２例患者中术前４例ＰＲＡ高于３０％，其中有３例术后一月内发生了急性排斥反应。结论：本实验室条件下建立的ＰＲＡ检测方法具有一定的稳定性和可靠性，对肾移植患者术后发生早期排斥反应有一定的预测价值。

OBJECTIVE To establish a method for panel reactive antibody detection and to evaluate ist value in predicting early renal graft rejection in chinese transplant patients.METHODOLOGY Sixtytwo healthy adults were included and their peripheral lymphocytes collected as the panel lymphocytes.PRA was detected in the pretransplantation serum of 120 patients who received renal grafits between Jun 1994 and Feb 1997 in our institute.RESULTS Both the retrospective and the prospective study revealed that pretransplantation PRA detection was valuable in predicting early graft rejection.Patients with PRA level above 30% were more susceptible to suffer from early graft rejection.than those below.CONCLUSION In consistency with previous report,the PRA assay is useful in predicting early renal graft rejection.