应用流式补体依赖淋巴细胞毒技术检测肾移植病人HLA抗体  

Detection of HLA Antibody by Flow Cytometry Complement-Dependent Technology in Patients with Renal Transplants

作　　者：叶欣[1] 肖露露[1] 易燕[1] 张伟东[1] 

机构地区：[1]广州血液中心临床输血研究所,广州510095

出　　处：《热带医学杂志》2008年第6期584-586,共3页Journal of Tropical Medicine

基　　金：2004年度广东省医学研究基金立项(No.A2004580)

摘　　要：目的为了更好地识别造成移植肾排斥的特异性抗供者HLA的IgG类型同种抗体,对Flow-CDC方法应用于肾移植及其临床相关性进行研究。方法对96例等候肾移植受者同时进行PRA、NIH-CDC和Flow-CDC实验,并观察其中34例接受NIH-CDC阴性肾移植术的受者近期移植效果。结果Flow-CDC和NIH-CDC两种实验方法的阳性率[27.8%(42/151)和17.3%(26/151)]之间差异有统计学意义(χ2=4.86,P<0.05)。另外,PRA阴性受者其NIH-CDC和Flow-CDC均为阴性,阴性吻合率为100%;在接受同种异体肾移植术的34例受者,其中20例PRA阴性受者接受了NIH-CDC和Flow-CDC均阴性供肾,移植后未发生排斥,移植肾功能迅速恢复;13例PRA阳性的致敏受者接受NIH-CDC和Flow-CDC均阴性供肾的,1例发生急性排斥经治疗后逆转,12例无排斥移植肾功能良好;1例PRA阳性再次移植受者接受了NIH-CDC阴性而Flow-CDC阳性的供肾,移植后第2天出现少尿,10 d切除移植肾。结论Flow-CDC方法是一种能够识别具有补体结合能力的抗供者特异性HLA抗体的交叉配型技术,比经典的NIH-CDC方法具有更敏感、可标准化、快速等优点,对预示肾移植术后的排斥反应方面更具有前瞻性。Objective To evaluate the clinical correlation of flow cytometry complement-dependent crossmatch （Flow-CDC） assay in renal transplantation. Method The sera of 96 renal allograft candidates were tested for PRA, Flow-CDC and NIH-CDC. The transplantation outcome in the 34 PRA positive patients who received renal transplantation were observed. Result The difference of positive ratio between Flow-CDC and NIH-CDC （27.8% vs 17.2%） was significant （X^2=4.86,P〈0.05）. For PRA negative patients, Flow-CDC and NIH-CDC were both negative. 20 PRA negative patients who received renal transplantation with both NIH-CDC and Flow-CDC negative had good outcome without rejection. 13 PRA positive patients who received NIH-CDC and Flow-CDC negative renal transplantation, 1 suffered from rejection and 12 patients had good outcome without rejection. The other one with the second transplantation suffered from acute rejection and lost his allograft 10 days post-transplant. For the second donor, NIH-CDC was negative but Flow-CDC was positive. Conclusion Flow-CDC can detect specially complement-fixing IgG alloantibodies against donor HLA and is more sensitive than NIH-CDC.

关 键 词：流式细胞术 淋巴细胞毒试验 补体结合抗体 肾移植 排斥反应 

分 类 号：R692[医药卫生—泌尿科学]