亲属肾移植患者术后群体反应性抗体和肾功能的研究

目的研究亲属肾移植患者术后群体反应性抗体(PRA)产生的频率和肾功能的变化,为预测移植肾长期存活提供参考资料。方法对2003年12月至2007年9月可追踪的74例亲属肾移植患者进行PRA检测和血肌酐/尿素氮观察。74例患者术前PRA均阴性。结果 23例患者接受了父亲提供的肾脏,5例PRA阳性患者,其中1例抗HLA-I+II类抗体,4例抗HLA-II类抗体。23例患者中21例患者血肌酐/尿素氮水平在正常范围,2例患者血肌酐/尿素氮水平不正常,且均为抗HLA-II类抗体患者。19例患者接受了母亲提供的肾脏,2例PRA阳性患者,其抗体分别为抗HLA-I+II类抗体和抗HLA-II类抗体,且血肌酐/尿素氮水平不正常。在26例兄弟姐妹之间供肾的患者中,25例患者血肌酐/尿素氮水平在正常范围,仅1例患者肾功能不正常;26例兄弟姐妹之间供肾的患者PRA均阴性。结论接受亲属移植肾的肾移植患者术后产生抗HLA抗体的几率低,移植肾功能良好。

Study of relation between posttransplantation PRA production and renal function in living donor kidney transplant recipients

Objective To investigate the incidence of panel reactive antibody（PRA）production in living donor kidney transplant recipients and its effect on renal function in order to provide data to predict the long-term survival of kidney transplant.Methods Posttransplantation PRA,serum creatinine and blood urea nitrogen were analyzed in 74 traceable patients who underwent living donor kidney transplantation between December,2003 and September,2007.Pretransplantation PRA was negative in all these patients.Results Five of 23 patients who received father＇s kidney showed PRA positive,with anti-HLA-I＋II positive in 1 patient,and anti-HLA-II positive in 4 patients;serum creatinine and blood urea nitrogen levels were normal in 21 of 23 patients and the 2 patients with abnormal levels of serum creatinine and blood urea nitrogen were all anti-HLA-II positive.Two of 19 patients who received mother＇s kidney showed anti-HLA-I＋II positive and anti-HLA-II positive,respectively,serum creatinine and blood urea nitrogen levels were higher than normal.Twenty-six recipients who received sibling＇s kidney showed PRA negative,and serum creatinine and blood urea nitrogen levels were normal in 25 of them.Conclusion The rate of PRA production is low for patients receiving kidney transplant from relatives,and the renal function is perfect after transplantation.