HLA配型、群体反应性抗体与肾移植术后早期急性排斥反应的关系

The relationship between HLA typing,PRA and early rejection after kidney transplantation

目的 :研究人类白细胞抗原 (HLA)配型、群体反应性抗体 (PRA)与肾移植术后早期急性排斥反应的关系。方法 :应用单克隆抗体板、微量序列特异性引物、混合抗原板进行供受者HLA I类抗原分型、HLA II类基因分型、PRA检测。结果 :PRA为低、中、高三组受者的早期急性排斥反应发生率分别为 16 %、2 7%、6 6 6 %。HLA位点错配数 (MM)为 0 1组明显比 5 6组早期急性排斥反应率低。结论 :良好的组织配型、低水平的PRA ,可降低早期急性排斥反应的发生。

Objective:To investigate the relationship between HLA typing, recipient's Panel reactive antibody (PRA) and early rejection after cadaver donor kidney transplantation.Methods:Donor and recipient HLA class I,II typing were performed with Paul Terasaki monoclonal antibody tray and Micro sequence specific primers respectively. PRA was detected by Paul Terasaki mixture antigen tray.Results:All donors were divided into three groups according to low, morderate, high PRA level and early acute rejection incidences of the three groups were 16%, 27% and 66.6%respectively.Early acute rejection incidence in patients with 0 1 HLA mismathching was signaficantly less than those with 5 6 HLA mismatching.Conclusion:The incidence of early rejection can be reduced greatly by selecting those recipients with low PRA and good HLA matching.