抗供体移植物特异性抗体与肾移植排斥的相关性研究

Relevance of Donor-Specific Anti-HLA Antibodies Following Renal Transplantation

为探讨抗供体特异性抗体与同种异体肾移植间移植物排斥的关系 ,用HLA位点氨基酸残基配对检测法 (ELISA -LAT -M和ELISA -LAT -ID) ,对 166例血清分为AR ,CR和正常对照共 3组进行筛选测定 .按LAT酶联检测试剂盒要求操作 ,抗体特异性的确定根据阳性结果的反应格局综合判断 ,结果显示抗HLAⅡ类IgG抗体阳性率分别为AR 38% ,CR 37% ,正常 2 3% (P <0 0 1) .提示HLAⅡ类抗体与急、慢性排斥反应有明显相关性 .进一步抗体定位并与其错配位点比较 ,抗移植物特异性HLAⅡ类IgG抗体阳性率AR 34 % ( 9例移植物丢失 ) ,CR 64% ( 1例移植物丢失 ) .提示抗移植物特异性HLAⅡ类IgG抗体是影响移植物存活和排斥反应的重要因素 。

To explore the correlation between the donor-specific anti-HLA antibodies posttransplant and the incidence of both severe acute rejection and chronic rejection, we analyzed. sera in these groups of AR, CR and normal control by HLA antibodies specificity LAT-Mixed to determine the presence or absence of anti-HLA class I or class II antibodies of the IgG isotype. Of these 123 recipients, 46 (37%) had class II-directed Abs. Positive samples were reanalyzed by an LAT-Id to verify the presence and Donor-specificity of the antibody. All 11 of AR recipients experienced at least 9 grafts loss. All 14 with CR also had 9 (64%) class II donor-specific antibodies. The results suggest that this technique identifies recipients with class I or class II donor antigen-specific antibodies and are at the significantly higher risk for AR and CR.