供体骨髓输注发生嵌合体与肾移植急性排斥反应的关系

目的：探讨供体骨髓输注发生嵌合体与肾移植急性排斥反应的关系及其临床意义.方法：将供体为男性的女性尸体肾移植患者55例,分为术前未行供体骨髓输注者30例（未输注组）;术前行供体骨髓输注的肾移植25例（输注组）.自末梢血中提取DNA,利用nested PCR法检测Y染色体上的特异基因片断DYZ-1.结果：证实有微嵌合发生共32例中13例（40.6%）、23例无嵌合体存的病例中有10例（43.5%）,都发生过1次或1次以上的急性排斥反应,两组之间比较差异无统计学意义;输注组中当微嵌合现象消失、PCR检测转为阴性时,未见排斥反应病例发生.结论：供体骨髓输注有利于促进微嵌合的形成,嵌合体的消失现象与急性排斥反应之间无相关关系,不能以此作为诊断急性排斥反应的依据.

The relationship between chimera generated from donor bone marrow infusion and acute rejection in renal transplantation

Objective:To explore the relationship between chimera generated from donator bone marrow infusion and acute rejection in renal transplantation.Methods:The subjects were 55 female recipients of cadaveric renal transplantation,whose donors were male.They were divided into 2 groups: 25 patients accept donor bone marrow infusion before the operation and 30 patients do not accept donor bone marrow infusion.Specific gene segment DYZ on Y chromosome in peripheral blood was examined by nested PCR.Results:We confirmed total 32 microchimera.There were 13 acute rejection patients((40.6)%) in microchimera patients group and 10 acute rejection patients((43.5)%) in non-microchimera patients group who had one or moor acute rejection episodes.There was no significant difference between the 2 groups.No acute rejection episodes were noted in patients with their microchimera disappeared.Conclusions:Donor bone marrow infusion can promote formation of microchimera,there are no relevance between microchimera disappearance and rejection.