腹腔器官移植供受者ABO血型基因型及其随机错配率的研究

Study on genotype of ABO blood type and random mismatch rate in donor-recipients of abdominal organ transplantation

目的探讨腹腔器官移植供、受者的ABO血型基因型的分布频率,分析移植供、受者在ABO血清型相同的基础上的基因型随机错配情况。方法肾移植受者89例、肝移植受者22例为受者组,同期86名无关随机供者为供者组。两组均采用单克隆抗体检测ABO血清学分型,同时采用聚合酶链反应-序列特异性引物(sequence-specific prime rpolymerase chain reaction,PCR-SSP)技术测定ABO血型基因型。所用引物可识别6个ABO血型基因(O1、O2、A1、A2、B1和B3)和21个ABO血型复等位基因。计算ABO血型基因频率,并在ABO血清学分型相同的基础上,分析供、受者之间ABO基因型的错配率。结果供者组和受者组均表达出O1、O2、A1、B1、A2共5个ABO血型基因和O1O1、O1O2、O2O2、A1A1、A1O1、A1O2、A2O1、A2O2、A1B1、A2B1、B1O1、B1O2和B1B1共13个ABO血型复等位基因;与其血清学分型一致率为100%。受者组及供者组患者中ABO血型基因频率从高到低依次为:O1(38.7%比43.0%)、O2(25.7%比21.5%)、A1(17.6%比18.0%)、B1(16.0%比16.3%)、A2(1.8%比1.2%),两组的分布频率比较差异均无统计学意义(均为P>0.05)。A型和B型中的杂合子血型基因型比例均超过85%。在ABO血清学同型的基础上,供、受者ABO基因的平均随机错配率为53.1%,其中供受者O→O的错配率为47.4%,A→A的错配率为66.8%,B→B的错配率为55.1%;AB→AB的错配率为16.7%。结论受者组及供者组患者中ABO血型基因频率从高到低依次为O1、O2、A1、B1、A2。在ABO血清学分型相同的基础上,供、受者ABO基因随机错配率较高。因此,有必要检测器官移植供、受者ABO血型基因分型,这有利于供受体间进行合理的配对。

Objective To investigate the frequencies of genotype of ABO blood type in donor and recipient （D-R） of abdominal organ transplantation, and the random mismatch rate of genotype in D-R based on the same ABO serotype. Methods Recipient group included 89 cases of renal transplantation and 22 cases of liver transplantation. Donor group included 86 cases of irrelevant random donors. ABO serotype was detected by monoclonal antibody in both groups. And ABO genotype was detected by sequence-specific primer poly- merase chain reaction （PCR-SSP）. The primer could recognize 6 ABO genes （O^1, O^2, A^1, A^2, B^1 and B^2 ） and 21 ABO multiple alleles. The ABO gene frequencies were calculated and random mismatch rate of ABO genotype between D-R was analyzed on the base of the same ABO serotype. Results There were 5 ABO genes （O^1, O^2, A^1, B^1, A^2） and 13 multiple aUeles （O^1O^1, O^1O^2, O^2O^2, A^1A^1, A^1O^1, A^1O^2, A^2O^1, A^2O^2, A^1B^1 , A^2B^1 , B^1O^1 , B^1O^2 and B^1B^1 ） expressed in D-R groups, which were 100 % consistent with serotypes. The frequencies of ABO genotype in donor group and recipient group were arranged from high to low respective-ly, including O^1 （38. 7 % vs 43.0 %）, 02（25.7 % vs 21.5 %）, A1（17.6 % vs 18.0 %）, B1（16. 2 % vs 16. 3 % ） and A2（ 1.8 % vs 1.2 % ）. There was no significant difference in the frequencies between two groups （ all in P 〉 0. 05 ）. The ratio of heterozygous genotype in A and B genotype was over 85 %. Based on D-R matched ABO serotype, the average rate of ABO genotype random mismatch was 53. 1%, including O O47.4%, A→A66.8%, B→B55.1% and AB→AB 16.7 %. Conclusions ThefrequeneiesofABO genotype in donor group and recipient group are arranged from high to low respectively, including 01 , 02, Am , B1 and A2. Based on matched D-R ABO serotype, the random mismatch rate of ABO genotype is higher. Therefore, it is necessary to detect ABO genotype of donors and recipients in organ transplantation and is good for advisable match between donors and recipients.