群体反应性抗体检测在肾移植中的应用

PRA determination in renal transplantation recipients

目的 了解肾移植受者的HLA体液致敏状态及致敏受者的HLA抗体特异性 ,筛选合适供者。 方法 应用配组淋巴细胞板通过微量补体依赖淋巴细胞毒试验检测 6 2 3例患者的群体反应性抗体 (PRA)。 结果 肾移植受者中PRA阳性受者占 11.5 % ,致敏受者移植后排斥反应发生率明显高于非致敏受者 (P <0 .0 1) ,而移植物存活率则显著低于非致敏受者 (P <0 .0 1)。移植后PRA水平升高组的排斥发生率和移植物丢失率均显著高于PRA无变化组 (P <0 .0 1) ,而排斥逆转率则显著低于后者 (P <0 .0 1)。 结论 PRA是预测受者致敏状态的一个敏感指标 ,对临床筛选合适供者 ,减少排斥反应 ,提高移植物存活率具有重要意义。

Objective To evaluate the HLA sensitivity status and the HLA antibody specificity of the renal transplant recipients to select the appropriate donors. Methods With the use of grouped lymphocytes tray, PRA level of 623 patients was measured by the micro complement dependent lymphocytotoxicity test. Results There were 11.5% PRA positive recipients among the 623 renal transplantation was patients .The incidence of rejection after transplantation obviouly higher in the sensitized recipients ( P <0.01) and the graft survival rate lower. Much higher rejection rate and graft loss rate were noted in recipience with high PRA level and the rejection reversing rate was also obviously lower. Conclusions PRA determinations is a sensitive factor predicting the sensitivity status of the recipients and plays a significant role in the selection of appropriate donors so as to achieve a decline of rejection rate and the increase of graft survival rate.