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亲属肾移植后群体反应性抗体的调查 被引量:4

Panel reactive antibody following living renal transplantation
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摘要 背景:亲属肾移植后产生群体反应性抗体的频率如何,对术后移植肾功能和长期存活是否有影响,目前国内尚无相关报道。目的:调查亲属肾移植后群体反应性抗体产生的频率,为预测亲属肾移植长期存活提供参考资料。方法:纳入2005-03/2007-10收治的亲属肾移植患者54例,分别于移植后一两年内再次检测群体反应性抗体及血肌酐、尿素氮浓度。群体反应性抗体检测采用美国Onelanmbda公司提供的酶联免疫吸附法筛选HLA-Ⅰ类、Ⅱ类混合抗原板。血肌酐和尿素氮检测数据由检验科提供。结果及结论:54例亲属肾移植患者中有7例移植后产生了抗体,占12.96%。其中6例产生了抗HLA-Ⅱ类抗体,仅1例产生了抗HLA-Ⅰ,Ⅱ类抗体。在此7例患者中6例为初次肾移植,且肾移植前群体反应性抗体均阴性;1例为再次肾移植,移植前抗HLA-Ⅱ抗体阳性。1例具有抗HLA-Ⅰ+Ⅱ类抗体和2例高强度抗HLA-Ⅱ类抗体的患者血肌酐和尿素氮浓度均超过正常水平,而另外4例出现低水平抗HLA-Ⅱ类抗体的患者血肌酐和尿素氮浓度则在正常水平。结果提示,具有抗HLA-Ⅰ+Ⅱ类抗体和高效价抗HLA-Ⅱ类抗体影响亲属肾移植患者的肾功能,而低效价的抗HLA-Ⅱ类抗体并不影响亲属移植肾功能。 BACKGROUND:It remains poorly understood regarding the incidence of panel reactive antibody(PRA) production and its influence to renal function and long-term survival in China.OBJECTIVE:To investigate the incidence of PRA after living renal transplant,so as to provide reference for predicting long-term renal survival.METHODS:A total of 54 patients who received living renal transplantation in Beijing Friendship Hospital from March 2005 and October 2007,were selected.PRA,serum creatinine and urea nitrogen level were detected 1-2 years after transplantation.PRA assay was conducted using One Lambda ELISA HLA-Ⅰ+Ⅱ antigen tray.Serum creatinine and urea nitrogen data were offered by clinical laboratory.RESULTS AND CONCLUSION:A total of 12.96%(7/54) patients showed PRA positive after transplantation,with HLA-Ⅱ antibody positive in 6 patients,and HLA-Ⅰ+Ⅱ antibody positive in 1 patient.In these 7 patients,6 underwent primary transplantation,and PRA negative before transplantation;1 patient underwent transplantation for the second time,and HLA-Ⅱ antibody positive before transplantation.Creatine and urea nitrogen level were abnormal in 1 patient with HLA-Ⅰ+Ⅱ antibody positive and 2 patients with HLA-Ⅱ antibody highly positive.Creatinine and urea nitrogen levels were normal in 4 patients with low level HLA-Ⅱ antibody.Results show that HLA-Ⅰ+Ⅱ antibody positive and high level HLA-Ⅱ antibody affect renal function in living renal recipients,but low level HLA-Ⅱ antibody has no effect on renal function.
出处 《中国组织工程研究与临床康复》 CAS CSCD 北大核心 2010年第5期799-802,共4页 Journal of Clinical Rehabilitative Tissue Engineering Research
基金 北京友谊医院科研启动基金资助项目~~
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  • 1WANG Dong,WU Wei-zhen,YANG Shun-liang,CHEN Jin-hua,TAN Jian-ming.Preoperative single-bolus high-dose antithymocyte globulin as induction therapy in sensitized renal transplant recipients[J].Chinese Medical Journal,2006(20):1683-1688. 被引量:5
  • 2Mckenna RM, Takemoto SK, Terasaki PI. Anti-HLA antibodies after solid organ transplantation. Transplantation, 2000,69 : 319 -326.
  • 3王乾 侯建全 何军 等.肾移括术后新合成(De Novo)HLA抗体对移植肾功能的影响[J].中华器官移植杂志,.
  • 4Terasaki PI, Ozawa M : Predicting kidney graft failure by HLA antibodies:a prospective trial. Am J Transplant,2004,4:438-443.
  • 5Lee PC ,Terasaki PI ,Takemoto SK,et al. All chronic rejection failures of kidney transplants were preceded by the development of HLA antibodies. Transplantation ,2002,74 : 1192-1194.
  • 6Worthington JE,Martin S,AI-Husseini DM,et al. Post-transplant production of donor HLA specific antibodies as a predictor of renal transplant outcome. Transplantation ,2003,75 : 1034-1040.
  • 7Muller-Steinhardt M , Fricke L, Kirchner H, et al. Monitoring of antl- HLA class Ⅰ and Ⅱ antibodies by flow cytometry in patients after first cadaveric kidney transplantation. Clin Transplant,2000,14:85-89.
  • 8Dilioglou S, Cruse JM, Lewis RE. High panel reactive antibody against cruss-reactive gruup antigens as a contraindication to renal allotransplantation. Exp Mol Pathol,2001,71:73-78.
  • 9Mauiyyedi S, Della Pelle P, Saidman S, et al. Chronic humoral rejection:identifieation of antibody-mediated chronic renal allograft rejection by CAd deposits in peritubular capillaries. J Am Soe Nephrol, 2001,12:574-582.
  • 10Theruvath TP, Saidman SL, Mauiyyedi S, et al. Control of antibody production with tacrolimus and mycophenolate mofetil in renal allograft recipients with chronic rejection. Transplantation ,2001,72:77-83.

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  • 1Worthington JE, Martin S, Al-Husseini DM, et al. Posttransplantation production of donor HLA-specific antibodies as a predictor of renal transplant outcome. Transplantation, 2003, 75(7):1034-1040.
  • 2Everly JJ, Walsh RC, Alloway RR, et al. Proteasome inhibition for antibody-mediated rejection. Curr Opin Organ Transplant, 2009, 14(6) :662-666.
  • 3Trivedi HL, Terasaki PI, Feroz A, et al. Abrogation of anti- HLA antibodies via proteasome inhibition. Transplantation, 2009, 87(10) : 1555-1561.
  • 4Everly MJ, Everly J J, Arend LJ, et al. Reducing de novo donor-specific antibody levels during acute rejection diminishes renal allograft loss. Am J Transplant, 2009, 9(5):1063-1071.
  • 5Everty MJ, Everly J J, Susskind B, et al. Bortezomib provides effective therapy for antibody- and cell-mediated acute rejection. Transplantation, 2008, 86(12):1754-1761.
  • 6Everly MJ, Everly JJ, Susskind B, et al. Proteasome inhibition reduces donor-specific antibody levels. Transplant Proe, 2009, 41 ( 1 ) : 105-107.
  • 7Caro-Oleas JL, Gonzdlez-Escribano MF, Gonzalez-Roncero FM, et al. Clinical relevance of HLA donor-specific antibodies detected by single antigen assay in kidney transplantation. Nephrol Dial Transplant, 2011, Aug 2. http://ndt. oxfordjournals, org.
  • 8Terasaki PI, Ozawa M, Castro R. Four-year follow-up of a prospective trial of HLA and MICA antibodies on kidney graft survival. Am J Transplant, 2007, 7(2):408-415.
  • 9Langan LL, Park LP, Hughes TL, et al. Post-transplant HLA class Ⅱ antibodies and high soluble CD30 levels are independently associated with poor kidney graft survival. Am J Transplant, 2007, 7(4) : 847-856.
  • 10Grafft CA, Cornell LD, Gloor JM, et al. Antibody-me- diated rejection following transplantation from an HLA-identical sibling [J]. Nephrol Dial Transplant, 2010,25(1) :307-310.

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