肾移植术后供受者MICA抗体对早期移植肾功能的影响  

Effect of donor and recipient anti-MICA antibodies on early renal graft function following transplantation

作　　者：付绍杰[1] 刘如敏[1] 罗敏[1] 杜传福[1] 王亦斌[1] 徐健[1] 肖露露[1] 于立新[1] 

机构地区：[1]南方医科大学南方医院器官移植科,广东广州510515

出　　处：《南方医科大学学报》2014年第3期383-386,共4页Journal of Southern Medical University

基　　金：国家自然科学基金(81350009);广东省科技计划项目(2009B080701019);广东省科技计划项目(2012B031800390);广州市白云区科技项目(2012-KZ-83)~~

摘　　要：目的探讨供受者主要组织相容性复合物I类相关链A(MICA)抗体对肾移植术后早期移植肾功能的影响。方法采用Luminex200液相芯片技术,对43对肾移植供受者进行MICA抗体检测,其中26例尸体供者,所对应的43例受者。分为四组:(1)供受者均为MICA抗体阳性组;(2)供者MICA抗体阳性、受者MICA抗体阴性组;(3)供者MICA抗体阴性、受者MICA抗体阳性组;(4)供受者均为MICA抗体阴性组。比较各组之间术后急性排斥反应(AR)发生率、1周时血肌酐水平、移植肾功能恢复时间等资料,分析供受者MICA抗体对早期移植肾功能的影响。结果 26例尸体供者中MICA抗体阳性者5例(19.2%),抗体特异性频率最高的是MICA*019(40%);43例受者中MICA抗体阳性者11例(25.6%),抗体特异性频率最高的是MICA*018(14.6%)。43例受者肾移植后AR分析显示,第1组未发生AR(0/1);第2组AR发生率为33.3%(2/6),第3组AR发生率为40%(4/10);第4组AR发生率为38.4%(10/26)。各组之间AR发生率无统计学意义(P>0.05);各组在术后1周时血肌酐水平以及移植肾功能恢复时间方面无统计学意义(均P>0.05)。结论供受者任何一方在肾移植前存在MICA抗体对术后早期受者的AR发生率和肾功能恢复无明显影响。Objective To investigate the effects of donor and recipient anti-major histocompatibility complex class I-related chain A （MICA） antibodies on early renal graft function in renal transplant recipients. Methods Using Luminex200 liquid chip technology, we detected anti-MICA antibodies in 26 deceased donors paired with 43 recipients. We divided the 43 pairs into 4 groups according to different donor and recipient anti-MICA antibody positivity statuses and compared the incidence of acute rejection （AR）, serum creatinine at 1 week after transplantation, and renal function recovery time between the groups to assess the effect of donor and recipient anti-MICA antibodies on early graft function. Results Five of the 26 donors were positive for anti-MICA antibodies （19.2%）, with the most common antibody being anti-MICA＊019 （40%）; 11 of the 43 recipients were positive for anti-MICA antibodies （25.6%）, among which anti-MICA＊018 was most frequently found （14.6%）. AR did not occur in the only anti-MICA antibody-positive recipient receiving an anti-MICA antibody-positive donor graft;AR occurred in 2 （33.3%） of the 6 anti-MICA antibody-negative recipients receiving anti-MICA antibody-positive donor graft, in 4 （40%） out of the 10 anti-MICA antibody-positive recipients receiving anti-MICA antibody-negative donor graft, and in 10 （38.4%） of the 26 anti-MICA antibody-negative recipients receiving anti-MICA antibodies-negative donor graft. The incidences of AR were not significantly different between the groups （P＆gt;0.05）, nor were serum creatinie levels or renal function recovery time at one week after surgery（P＆gt;0.05）. Conclusion Donor or recipient anti-MICA antibody positivity does not seem to significantly affect the incidence of AR or renal function recovery early after transplantation to justify the necessity of monitoring donor anti-MICA antibodies. But still, large-sample studies are needed to further investigate the potential impact of donor and recipient anti-MICA anti

关 键 词：肾移植 移植肾功能 急性排斥反应 

分 类 号：R699.2[医药卫生—泌尿科学]