造血干细胞输注在肾移植中的临床应用

Combination of kidney transplantation with hematopoietic stem cell infusion

对1998年2月至2005年12月行供者肾脏、造血干细胞联合移植（联合移植组，48例）和同一供者肾脏移植（对照组，48例）患者进行术后移植肾存活率（剔除带功死亡者）随访比较。术后1、3、5及10年，移植肾存活率联合移植组分别为98％（47／48）、94％（45／48）、83％（34／41）和9／17，对照组分别为98％（47／48）、90％（43／48）、76％（31／41）和7／17。慢性排斥反应的发生，联合移植组为2％（1／48）、对照组为17％（8／48）（P〈0．05）。供者造血干细胞输注能诱导肾移植患者免疫耐受产生,减少排斥反应的发生,提高患者的生存质量。

Ninety six female patients with chronic renal failure were randomly allocated into combination group （n = 48） and control group （n = 48）. In combination group patients received both kidney transplantation and hematopoietic stem cell infusion, in control group patients underwent kidney transplantation only. The results showed that chronic rejection in the combination group was lower than that in the control group [2% （1/48） vs. 17% （ 8/48 ）, P 〈 0.05 ） 1- The 1-, 3-, 5- and 10 y-survival rates of kidney in the combination group were 98% （ 47/48 ）, 94% （ 45/48 ）, 83% （ 34/41 ） and 9/17, respectively, those in control group were 98% （47/48）, 90% （43/48）, 76% （31/41） and 7/17, respectively. Infusion of donor hematopoietic stem cells can augment chimerism in early postoperative period and significantly reduce the rate of graft rejection, which is beneficial for the quality of life of the recipients.