供体脾灌注对高度致敏肾移植受者嵌合体形成的影响  

Impact of Donor Spleen Perfusion on Chimerism of Highly Sensitized Renal Transplant Recipients

作　　者：吴建军[1] 谢森[1] 郑山根[1] 唐礼功[1] 刘幼英[1] 成俊[1] 夏穗生[1] 

机构地区：[1]广州军区武汉总医院,武汉430070

出　　处：《华南国防医学杂志》2008年第3期30-33,共4页Military Medical Journal of South China

摘　　要：目的探讨供体脾灌注对高度致敏肾移植受者稳定期嵌合体形成及移植肾功能的影响。方法对16例高度致敏患者进行配对分组,实验组肾移植术中先予供体脾灌注40min,前瞻性观察脾灌注对患者术后6个月内嵌合体形成、移植肾排斥反应发生及移植肾功能的变化。结果脾灌注后受者外周血中供者来源的有核细胞数量显著增加,受者形成稳定嵌合体的时间较早,例数比对照组更多;肾移植术后脾灌注组排斥反应发生时间较对照组延迟,排斥反应严重程度明显较对照组轻微;术后6个月时,脾灌注组患者血肌酐值低于对照组。结论供体脾灌注可以显著提高高敏肾移植受者外周血中供者来源的有核细胞数量,减轻排斥反应强度,从而促进受者嵌合体的形成,有利于改善稳定期移植肾功能。Objective To assess the impact of donor spleen perfusion on the formation of chimerism and the graft kidney function in highly sensitized renal transplant recipients. Methods Sixteen highly sensitized patients were pairwise divided into experimental and control groups. 40min of donor spleen perfusion was performed before renal transplant. Chimerism in recipients, rejection episodes of renal allografts and renal allograft function within 6 months after operation were observed. Results Donor lymphocytes in peripheral blood of recipients increased significantly after donor spleen perfusion. Compared with control, in experimental group time of stable chimerism establishment was earlier and more patients had stable chimerism. Rejection presenting time was delayed and the severity of rejection was milder. The serum creatinine level was also significantly lower than that of control 6 months postoperatively. Conclusion Donor spleen perfusion may transfer a large amount of donor lymphocytes to the highly sensitized recipients circulation, attenuate the rejection severity,and facilitate the establishment of stable chimerism so as to improve the graft function.

关 键 词：肾移植 致敏 脾脏 嵌合体 

分 类 号：R699.2[医药卫生—泌尿科学]