难治性排斥反应移植肾组织中C4d阳性表达的意义

目的检测C4d在难治性排斥反应移植肾组织中的表达情况,分析体液性排斥反应在移植肾丢失中的可能性作用。方法选择因难治性排斥反应致移植肾切除标本为研究对象,应用兔抗人C4d多克隆抗体对标本石蜡切片进行免疫组化染色,检测C4d在失功移植肾中的表达情况,统计失功移植肾的存活时间,分析体液性排斥反应对移植肾存活的影响。结果 40例失功移植肾标本中,C4d阳性17例(42.5%)。40例移植肾存活时间:2周～110个月,平均为(35.0±7.5)个月。经统计学分析:C4d阳性移植肾存活时间为(39.2±8.3)个月,C4d阴性移植肾存活时间为(65.7±6.2)个月。两组比较差异具有统计学意义(P=0.030 9)。结论体液性排斥反应的发生是影响移植物长期存活的危险因素。

The significance of positive expression of C4d in renal graft tissues with refractory humoral rejection

Objective To detect the expression of C4d in renal graft tissues with refractory humoral rejection,explore the possibility role of humoral rejection in renal graft loss.Methods The specimens of excised renal allograft caused by refractory rejection were selected as research objects,immunohistochemical staining for paraffin section of specimen were performed by rabbit polyclonal antibody against human C4d,the expression of C4d in nonfunctional renal graft were measured.The survival time of nonfunctional renal graft and the effect of humoral rejection on survival time of nonfunctional renal graft were recorded and analyzed.Results In a total of 40 cases of nonfunctional renal graft,17 specimens were positive for C4d(42.5%).The survival time of 40 cases: 2 weeks to 110 months,average of(35.0±7.5) months.The statistical analysis demonstrated that the renal graft survival rate in patients with C4d positive expression was(39.2±8.3)months and with C4d negative expression was(65.7±6.2)months.The difference between the two groups showed statistical significance(P=0.0309).Conclusion Humoral rejection is one of high risk factor for long-term graft survival.