血液透析致肾移植患者术前产生抗HLA抗体的研究

Study on the characteristic of anti-HLA antibody produced by hemodialysis in renal transplantation patients before operation

目的了解肾移植术前血液透析导致抗人类白细胞抗原(human leukocyte antigen,HLA)抗体产生的几率及分布特点.方法收集2015年1月至2017年12月本院肾移植前无致敏史患者血清样本共169例,应用Luminex 200检测平台及相应试剂检测抗HLA抗体,并进行分析.结果经血液透析的169例患者中,64.50%(109/169)的患者产生抗HLA抗体;随着血液透析时间的延长,抗HLA抗体产生的阳性率增加,但差别无统计学意义(χ^2=6.009,P>0.05);共检出186个抗HLAⅠ类抗体,158个抗HLAⅡ类抗体;抗HLAⅠ类抗体中,以抗-A11、A25、A66、A80、B8、B75、B76和Cw17出现的频率较高,抗HLAⅡ类抗体中,以抗-DR4、DR51、DR52、DR53、DQ2、DQ4、DQ6、DQ7、DP1、DP5、DP11和DP13出现的频率较高.结论无致敏史肾移植术前患者经血液透析治疗后体内会产生抗HLA抗体,血液透析可能是致敏的另一个因素,临床上应予以关注.

Objective To understand the distribution and probability of anti-human leukocyte antigen(anti-HLA)antibody produced by hemodialysis before renal transplantation.Methods A total of 169 serum samples were collected from January 2015 to December 2017,from patients without sensitization history before kidney transplantation in our hospital.Anti-HLA antibodies were detected using Luminex 200 detection platform and corresponding reagents,and then the data was analyzed.Results 64.50%(109/169)of the 169 hemodialysis patients produced anti-HLA antibody.With the prolongation of hemodialysis time,the positive rate of anti-HLA antibody in patients′serum increased,but the difference was not significant(χ^2=6.009,P>0.05).186 anti-HLA ClassⅠantibody and 158 ClassⅡantibody detected.Among the anti-HLA ClassⅠantibody,the highest frequency antibody were anti-A11,A25,A66,A80,B8,B75,B76,and Cw17.Among anti-HLA ClassⅡantibody,anti-DR4,DR51,DR52,DR53,DQ2,DQ4,DQ6,DQ7,DP1,DP5,DP11 and DP13 were higher.Conclusions Anti-HLA antibody can be produced by patients with non sensitized renal transplantation after hemodialysis.Hemodialysis may be another factor of sensitization,which should be paid attention to in clinic.