肾移植长期存活患者PRA与肾功能的关系研究

Exploring the correlation between PRA panel reaction antibody and renal function of long-term survival kidney transplantation recipients

目的研究肾移植长期存活者群体反应性抗体(PRA)与肾功能的关系。方法于2014年2月回顾首都医科大学附属北京友谊医院肾移植长期存活者的临床资料,对2007年前已完成肾移植手术且接受过PRA检测的肾移植受者进行临床随访跟踪,共有707例患者进行了肾功能观察,分析抗HLA抗体与肾移植受者移植物长期存活的相关性。结果肾功能评估完成时间2014年10月,707例肾移植受者中PRA阴性共403例,肾功能正常共347例,肾功能异常共56例;PRA阳性共304例,肾功能正常75例,肾功能异常229例,707例移植物长期存活的肾移植受者中抗HLA抗体阳性和阴性患者对肾功能的影响差异具有统计学意义(χ2=269.25,P<0.0005)。结论抗HLA抗体的产生可能影响肾移植受者术后移植物的长期存活及存活质量。

Objective The objective of this study is to explore the correlation between PRA and renal function of kidney transplantation recipients who obtain long-term living allografts.Methods All of the kidney transplantation recipients who obtain living allografs for at least 5years in Beijing Friendship hospital were collected retrospectively,and 707 case among them underwent renal function evaluation during following up.PRA analysis was conducted by HLA-Ⅰand HLA-Ⅱmixed antigen screened by ELISA（ Lambda Cell Trays TM）.Results The offtime of renal function evaluation is Oct.2014.Among 707 long-term survival KTRs,403 cases delivered PRA negative,and 347 cases of PRA negative showed normal renal function,56 cases of PRA negative showed renal function damaged or lost.304 cases delivered PRA positive,and 75 cases of PRA negative showed normal renal function,229 cases of PRA negative showed renal function damaged or lost.The PRA negative and positive proportions of long-term survival kidney transplantation recipients who showed normal renal function were 86.1% and 24.7%（ χ2= 269.25,P〈 0.0005）.Conclusion Anti-HLA antibody is associated with renal function among the KRTs who obtain long-term living allografts,and PRA negative may play a protective role for them.