良好的HLA配型可改善群体反应性抗体高的受者肾移植效果

Good HLA matching can improve the transplant results in PRA hypersensitivity recipientsYU Lixin, FU Shaojie, XIAO Lulu, et al. Department of Kidney Transp

目的探讨ＨＬＡ配型在高致敏受者肾移植中的意义。方法对１２例群体反应性抗体为３６％～７６％的肾功能衰竭患者使用特异性单克隆抗体ＨＬＡⅠ、Ⅱ类抗体分型盘进行ＨＬＡ配型。结果供、受者ＨＬＡＡ、Ｂ、ＤＲ位点各有一个抗原相符者３例；ＨＬＡＢ位点２个抗原、ＤＲ位点１个抗原相符者１例；ＨＬＡＡ位点１个抗原、Ｂ位点２个抗原、ＤＲ位点１个抗原相符者６例；ＨＬＡＡ位点２个抗原、Ｂ位点１个抗原、ＤＲ位点２个抗原相符者２例。术后７例发生急性排斥反应，经冲击６例逆转，１例摘除移植肾。１１例肾功能恢复正常。

Objective To investigate the role of HLA matching in kidney transplantation of hypersensitivity recipients. Methods Twelve renal function failure patients with population reactive antibody (PRA) positive rate of 36% to 76% accepted successful HLA matching by using specific monoclonal antibodies HLA, HLA antigen typing dishes. Results Three recipients were in conformation with donors in one antigen at each HLAA, B, DR locus, one in two antigens at HLAB loci, one antigen at DR loci, 6 in one antigen at HLAA loci, two antigens at B loci and one antigen at DR, 2 in 2 antigens at HLAA loci, one antigen at B and two antigens at DR loci. Acute rejection occurred in 7 cases after operation, but 6 cases recovered by using methylprednisolone and OKT3, and 1 case's graft was extracted on the 23rd day after operation. The renal function in 11 cases returned to normal. Conclusion HLA matching might play an important role in kidney transplantation of hypersensitivity recipients.