肾移植后人类白细胞抗原抗体检测的临床意义

目的：了解肾移植受者的抗人类白细胞抗原（HLA）IgG抗体水平及其对肾移植效果的影响。方法：应用莱姆德抗原板和混合抗原板通过微量酶联免疫吸附法检测685例患者的抗HLA特异性IgG 抗体。结果：685例肾移植受者中HLA－IgG抗体阳性者占12％，致敏受者移植后排斥反应发生率为50％，明显高于HLA－IgG抗体阴性受者（P＜0．01），而移植物存活率则显著低于HLA－IgG抗体阴性受者（P＜0．01），移植后HLA－IgG抗体水平升高组，其排斥发生率和移植物丢失率分别为82％和77％，均显著高于HLA－IgG抗体无变化组（P＜0．01），而排斥逆转率则显著低于后者（P＜0．01）。结论：HLA－IgG抗体是预测受者HLA免疫致敏的一个敏感指标；动态监测HLA－IgG抗体水平的变化对临床筛选合适供者，减少排斥反应，提高移植物存活率重要意义。

Detection of anti-HLA antibodies and clinical implication after kidney transplantation.

Objective To evaluate the level of specific anti human leukocyte antigen IgG antibodies and its effect on renal transplantation Methods Specific anti HLA IgG antibodies of 685 serum samples were measured by the micro enzyme linked immunosorbent assay with Lambda Antigen Tray and Lambda Antigen Tray Mixed Results There were 12% positive recipients of anti HLA IgG antibodies among 685 renal transplantation patients The rates of allografts rejection after transplantation were 50% and obviously higher in the sensitized recipients than in non sensitized ones ( P <0 01), while grafts survival rate were obviously lower than non sensitized recipients The rates of grafts rejection and grafts loss in group with increased anti HLA IgG antibodies level of recipients after transplantation were 82% and 77% respectively and obviously higher than the one without change of anti HLA IgG antibodies, and the rejection reversing rate was obviously lower than the later Conclusion Specific anti HLA IgG antibodies is a sensitive factor predicting the sensitized status of recipients by HLA of donors Dynamically monitoring of anti HLA antibodies and its specificities plays a significant role in the clinical selection for appropriate donors, the decrease of the rejection episodes and the increase of graft survival rate