肾移植术后供体细胞移行嵌合现象的研究

目的 研究肾移植术后供体细胞移行嵌合状况与移植肾功能及排斥反应发生情况的关系。方法 采用聚合酶链反应(PCR)方法扩增Y染色体特异性DNA片断,对30例接受男性供肾的女性肾移植受者外周血及皮肤进行供体细胞嵌合的检测。结果 30例受者总细胞移行嵌合发生率为 63％(19/30),术后2周内移行嵌合率为 30％(9/30),3个月内为 40％(12/30),24个月为76％(19/25)。经30例受者连续随访观察表明,发生移行嵌合的受者移植肾功能较未发生受者为好,排斥反应发生次数也较少,两者差异有显著性(P<0.05)。结论 肾移植术后细胞移行嵌合发生率随移植肾存活时间延长而升高。供体细胞移行嵌合的发生有利于移植物存活。

Cell migration and microchimerism after kidney transplantation

Objective To study the relationship between cell migration and microchimerism and kidney allograft function and rejections. Methods By PCR technique, a Y chromosome specifical DNA sequence was detected in 30 female renal allograft recipients using male kidneys as donors. The mi- crochimerism in peripheral blood and skin was detected. Results Donor cell migration and mi- crochimerism was detected in 63 % (19/30) of the subjects, in 30% (9/30) of those recipients within 2 weeks, in 40% (12/30) of those recipients from 3 weeks to 3 months, and 76% (19/25) of those recipi- ents beyond 24 months. In 30 renal recipients, the migration and microchimerism has been continuously studied in 24 months after transplantation. In migration and microchimerism positive recipients, the inci- dence of rejection was lower (P < 0. 05), and the serum creatinine level was lower than in the negative ones (P < 0. 05). Conclusion Donor cell migration and microchimerism is more frequently in recipients with longer allograft survival and helpful to clinical transplantation practice.