亲属与非活体肾移植术后抗HLA抗体和肾功能的比较
Comparison of HLA antibody production in living donor and cadaveric transplant
摘要目的 比较亲属肾移植和非活体肾移植术后患者群体反应性抗体(PRA)产生的频率,为预测移植肾长期存活提供参考资料.方法 回顾性分析2003年12月一2007年9月48例术后亲属肾移植患者和258例2003年2月-2007年6月术后非活体肾移植PRA.此两组肾移植患者肾移植前PRA均阴性.PRA检测采用美国莱姆德公司抗原筛选板和美国GTI公司提供的ELISA筛选HLA-Ⅰ类、Ⅱ类混合抗原板.结果 48例亲属肾移植中仅有4例为PRA阳性,占8.33%.258例尸体肾移植中PRA阳性患者有62例,占24.03%,两者之间差异有统计学意义(P<0.05).亲属肾移植男性患者35例,抗体阳性3例,占8.57%.非活体肾移植男性患者152例,抗体阳性患者35例,占23.03%,两者之间具有显著性差异(P<0.05).亲属肾移植女性患者13例,仅1例出现抗HLA-Ⅱ类抗体.非活体肾移植女性患者106例,抗体阳性患者20例,占18.87%,两者之间具有显著性差异(P<0.05).结论 非活体肾移植患者术后产生的抗HLA-抗体的机率高于亲属肾移植患者.
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abstractsObjective To compare the Panel reactive antibody (PRA) producing incidence in living and cadaveric transplant for forecasting long term survival. Methods Retrospectively analyze post-transplant PRA of 48 living transplant patients ( December 2003-Sepdtember 2007 ), and 258 cadaveric transplant patients( Feburary 2003-June 2007 ), which in both groups were all PRA negative in pre-transplant. PRA was detected using LAT-1240 (OneLambda) and QUICKSCREE&BSCREEN (GTI). Serum creatine/urea nitrogen level was provided by clinical laboratory. Results Four recipients in 48 living transplant patients showed PRA positive(8.33% ), while 62 receipients in 258 cadaveric transplant patients showed PRA positive(24.03% ) ( P <0.05 ). Three recipients in 35 male living donor transplant patients showed PRA positive(8.57% ) ,while 23.03% PRA positive in male cadaveric transplant patients (P <0.05). In females, 1out of 13 living donor transplant patients showed HLA-Ⅱ positive, whereas 20 out of 106 in cadaveric transplant patients( 18.87% ) ( P < 0. 05). Conclusion The incidence of HLA antibody production was much higher in cadaveric transplant patients than that in those of living donor transplant.
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