肾移植供、受者KIR基因和KIR配体相关基因的错配对移植效果的影响  

Analysis of actual mismatch risk for KIR genes and KIR ligand related genes in kidney transplant recipients

作　　者：于立新[1] 周敏捷[1] 罗敏[1] 

机构地区：[1]南方医科大学南方医院器官移植科,510515

出　　处：《中华器官移植杂志》2013年第5期265-268,共4页Chinese Journal of Organ Transplantation

基　　金：国家自然科学基金（81070594）;国家自然科学基金（81141058）;广东省科技计划项目（20108316（）0240）

摘　　要：目的评价肾移植供、受者间自然杀伤细胞免疫球蛋白样受体（KIR）基因、KIR配体HL良C基因和KIR配体HLA-Bw4180相关基因的实际错配概率及其对受者急性排斥反应（AR）的影响。方法对322例肾移植受者以及相应的196例尸体肾移植供者的KIR基因、KIR配体HLA-C基因、KIR配体HLA-Bw4180相关基因的错配概率进行分析，同时研究KIR配体HLA-Bw4180相关基因错配与AR发生率及AR逆转率的关系。结果322例受者与相应供者间KIR-L基因平均错配概率为4．73％，KIR-S基因平均错配概率为9．10％，KIR配体HLA-C基因平均错配概率为1．95％。322例受者中，与相应供者KIR配体HLA-Bw4180相关基因发生错配的有245例（76．09％），无错配的有77例（23．91％）。245例KIR配体HLA-Bw4180相关基因错配组的AR发生率为8．16％，77例无错配组的AR发生率7．79％（P〉0．05）；错配组AR逆转率为95．0％，无错配组AR逆转率为66．7％（P〉0.05）。结论肾移植供、受者间KIR配体HLA-Bw4180相关基因错配概率较高，其错配对AR逆转的影响尚需进一步大样本研究来验证。Objective To evaluate the actual mismatch risk for KIR genes, KIR ligand HLA-C gene and KIR ligand HLA Bw4180 related genes in kidney transplant recipients and their donors. Method KIR genes, KIR ligand HLA-C gene and KIR ligand HLA-Bw4180 related genes were analyzed in 322 recipients and their donors who received kidney transplantation. The effect of mismatches on acute rejection after transplantation was studied as well. Result In 322 cases of recipients and their donors, average mismatch risk for KIR-L gene was 4. 730//oo, 9. 10% for KIR-S gene and 1. 95% for KIR ligand HLA-C gene respectively. There were 245 cases （76. 09%） of KIR ligand HLA-Bw4IS0 related genes mismatch and 77 cases （23. 91 %） of match resepctively. There was no statistically significant difference in AR rate between KIR ligand HLA-Bw4IS0 related genes mismatch group and match group （8. 16% in 245 vs. 7. 79% in 77） （P〈0. 05）. AR reversal rate in mismatch group and match group was 95. （ and 66. 7% （P〈0. 05）. Conclusion The mismatch risk for KIR ligand HLA-Bw4IS0 related genes was even common between kidney transplant recipients and their donors, and this specific mismatch may be of benefit to patients who undergo actuate rejection. Further study is still required.

关 键 词：肾移植 基因 移植物排斥 

分 类 号：R699.2[医药卫生—泌尿科学]