同一供肾者移植成对患者抗HLA抗体对肾功能的对比研究

Comparative Study on Allograft Functions of HLA Antibody in Patients Who Received Pairs of Allograft from the Same Donor

目的：研究接受同一肾移植供者移植肾的成对患者与抗 HLA抗体对移植肾功能的影响。方法研究对象为首都医科大学附属北京友谊医院2008年前手术患者，并于2008年10月-2009年4月检测抗 HLA抗体。近期（2013年10月-2014年2月）对可追踪到的113对共计226例肾移植患者观察肾功能（血肌酐/尿素氮）状态。群体反应性抗体（PRA）检测采用美国One lambda公司提供的ELISA筛选HLA-I类、II类混合抗原板。血肌酐/尿素氮检测数据由北京友谊医院检验科提供。结果同性别的男性、女性和两个受者为异性的患者分别为41对82例、21对42例和51对102例患者。抗体阳性患者分别为26例（仅4对患者抗体同时阳性）、11例（仅1对抗 HLA-II类抗体阳性）和36例（仅5对患者共同产生抗体）。在113对226例肾移植中，73例抗 HLA抗体阳性患者中，肾功能下降或丧失的患者64例；而153例抗HLA抗体阴性患者中，肾功能下降或丧失的患者仅4例，两者间差异具有统计学意义（χ2＝160.70，P＜0.001）。结论抗HLA抗体是影响移植肾功能和长期存活的重要因素。

Objective To study the influence on allograft function of HLA antibody in patients who received pairs of allograft from the same donor.Methods In Beijing Friendship Hospital.HLA antibodies were tested from October,2008 to April 2009 in patients.Recently （October,2013-February,2014）,renal functions（serum creatinine/urea nitrogen）were studied in 226 patients who received transplant from 113 donors.LATM10x5,One Lambdas used for Panel reactive antibody screen-ing.Results 41 pairs of renal for male,21 pairs of renal for female and 51 pairs of renal for both male and female.PRA posi-tive in 26 patients （only 4 pairs of renal for patients were positive）,11 recipients （HLA II antibody positive in only 1 pair of renal for patients）and 36 recipients （only 5 patients produced antibody）in 226 patients,HLA antibody positive in 73 pa-tients,in which renal function lost or decreased in 64 patients.HLA antibody negative in 153 recipients,in which renal func-tion lost or decreased in 4 patients.There was significant difference between the two group （χ2=160.70,P〈0.001）.Con-clusion HLA antibody is a important factor influence renal function and long term survival.