肾移植术后供者特异性抗体对移植肾近期效果的影响 |
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引用本文: | 刘志宏,谭建明,胡志林,范昱,丁言德. 肾移植术后供者特异性抗体对移植肾近期效果的影响[J]. 中华器官移植杂志, 2003, 24(6): 356-358 |
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作者姓名: | 刘志宏 谭建明 胡志林 范昱 丁言德 |
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作者单位: | 1. 200080,上海市第一人民医院移植泌尿外科,上海市器官移植临床医学中心 2. 辽宁省大连市友谊医院泌尿外科 |
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摘 要: | 目的 评价肾移植术后供者特异性抗体(Ds-Ab)对移植肾近期效果的影响。方法 对2001年1月至2002年7月间进行尸肾移植的92例受者,使用酶联免疫吸附(ELISA)法,检测受者血清中HLA抗体水平,随访1年。结果 16例(17.4%)受者术后出现供者特异性抗体。抗体阳性组急性排斥发生率(56.3%)高于抗体阴性组(11.9%),P=0.000;移植肾功能延迟恢复的发生率(12.5%)与抗体阴性组(9.2%)比较,差异无显著性,P=0.102;供者特异性抗体阳性组受者发生急性排斥后,移植肾肌酐水平高于抗体阴性组或无急性排斥组。结论 供者特异性抗体与肾移植术后急性排斥有关,可能影响近期移植肾功能。
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关 键 词: | 肾移植术 特异性抗体 移植肾 近期效果 影响 |
Impact of donor-specific antibodies on kidney graft short-term survival |
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Abstract: | Objective To evaluate the clinical relevance of donor-specific antibodies (Ds-Abs) and allograft short-term survival. Methods Pre- and post-transplant sera of 92 cadaver kidney recipients who were followed-up for one year after transplantation were tested by ELISA for anti-HLA antibodies from 2001.1 to 2002.7 . Results 16 ( 17.4?% ) resulted positive for Ds-Abs production among 92 patients. Nine of 16 ( 56.3?% ) Ds-Abs positive patients suffered acute rejections vs. only 9 of 76 ( 11.9?% ) Ds-Abs negative patients ( P = 0.000 ). Correlating delayed graft function (DGF) to Ds-Abs production, 2 of 16 ( 12.5?% ) Ds-Abs positive recipients experienced DGF vs. 7 of 76 ( 9.2?% ) Ds-Abs negative recipients ( P = 0.102 ). A worse graft function was evidenced in Ds-Abs positive subjects with acute rejection episodes than in those who had acute rejection but did not produce Ds-Abs or no rejection but produced Ds-Abs. Conclusion Donor-specific antibodies play an important role in acute rejection episodes after kidney transplantation. When comparing with sera creatinine levels, a strong link between Ds-Abs positive and graft short-term outcome is further evidenced. |
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Keywords: | Kidney transplantation Antibody specificity Graft rejection |
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