亲属活体肾和造血干细胞联合移植诱导免疫耐受研究

Clinical Study of Simultaneous Kidney Transplantation and Haemopoietic Stem Cell Transfusion on Inducing Immunotolerance

目的探讨亲属活体肾造血干细胞联合移植诱导免疫耐受的可行性及安全性。方法对3例女性尿毒症患者进行亲属活体肾造血干细胞联合移植(观察组);同期接受亲属活体肾移植的5例女性尿毒症患者作为对照组。供体均为男性。采用PCR-SRY方法进行嵌合体检测。测定受体淋巴细胞亚群,随访观察肾造血干细胞联合移植的并发症和临床移植效果并与对照组进行比较分析。结果观察组嵌合体阳性率100%,对照组60%;观察组肾移植受者临床效果良好,呈现免疫低反应和免疫抑制趋势。结论亲属活体肾造血干细胞联合移植是一种可行的诱导免疫耐受的方法,可以诱导产生临床肾移植的免疫低反应。

Objective To study the feasibility and security of simultaneous kidney transplantation and haemopoietic stem cell transfusion on inducing immunotolerance. Methods The transplant outcome, chimerism, intragraft immunocompetent state and some cytokines were analysed and compared between 3 patients undergo simultaneous kidney transplantation and haemopoietic stem cell transfusion and 5 living- related renal allogrft recipients. Results The rate of chimerism positive was 100% in experiment group and it was 60% in control group. In experimental group, the renal allograft function was normal and the immuno - hyporeaotivity was expressed in clinic and intragraft immunocompetent state. Conclusion It was believed that the simultaneous kidney transplantation and haemopoietic stem cell transfusion could induce recipients specific tolerance to renal allograft.