HLA抗体对肝移植术后急性排斥发生的影响  

Effects of the HLA antibodies on allograft acute rejection after cadaveric liver transplantation

作　　者：陈伟[1] 陈规划[2] 陆敏强[2] 杨扬[2] 蔡常洁[2] 侯宝华[1] 林叶[1] 张伟东[3] 肖露露[3] 

机构地区：[1]广东省人民医院肝胆外科,广东广州510080 [2]中山大学附属第三医院器官移植研究所肝脏移植中心,广东广州510630 [3]广州器官移植配型中心,广东广州510095

出　　处：《南方医科大学学报》2006年第6期774-776,共3页Journal of Southern Medical University

基　　金：广东省自然科学基金(5300816);广东省科技计划项目(2002B30207-3)~~

摘　　要：目的探讨肝移植手术前后HLA抗体变化对移植肝脏急性排斥的影响。方法134例患者接受改良背驮式肝移植,分别于手术前、手术后第1、7、14、30日通过酶联免疫吸附(ELISA)法检测HLA抗体,通过B超引导下肝穿刺病理检查明确有无急性排斥,观察肝移植前后HLA抗体变化对急性排斥发生的影响。结果术前HLA抗体阳性组急性排斥发生率(56.8%)显著高于术前HLA抗体阴性组(25.9%)(P=0.001);术前HLA抗体阴性而术后转为阳性组急性排斥发生率与术前术后HLA抗体均为阴性组有显著差异(P=0.003)。结论患者术前HLA抗体阳性可能是引起肝移植术后急性排斥的原因之一,患者术后HLA抗体持续阳性与急性排斥的发生密切相关。Objective To evaluate the effect ofperioperative HLA antibody changes on acute allograft rejection in cadaveric liver transplantation. Methods Totally 134 patients received modified piggyback liver transplantation and enzyme-linked immunosorbent assay was performed for HLA antibody detection before and the 1, 7, 14 and 30 days after operation. B ultrasound-guided liver biopsy was employed for diagnosis of acute allograft rejection, and the perioperative changes of HLA antibodies were evaluated for their effect on allograft acute rejection. Results Of the 44 recipients with preoperative positivity for HLA antibodies, acute rejection occurred in 56.8% of the patients, as compared with 25.9% in those negative for HLA antibody （P=0.001）. The patients who became positive for HLA antibody postoperatively had a rate of acute rejection of 60%, which was significantly higher than that in those persistently negative for HLA antibody （18.6%, P=0.003）. Conclusion HLA antibody positivity before transplantation may contribute to acute rejection episode in liver transplantation, and persistent posttransplant HLA antibody positivity is closely associated with the occurrence of acute rejection.

关 键 词：肝移植 HLA抗体 急性排斥反应 

分 类 号：R657.3[医药卫生—外科学]