PRA配型技术在肾移植中的应用研究  

Evaluation of the effect of examining histocompatibility of panel reactive antibody before renal transplantation

作　　者：于立新[1] 萧露露[2] 付绍杰[1] 白喜文[1] 韩献平[3] 马俊杰[1] 徐健[1] 叶桂荣[1] 邓文锋[1] 杜传福[1] 

机构地区：[1]第一军医大学南方医院肾移植科,广州510515 [2]广州器官移植配型中心,广州510095 [3]第一军医大学南方医院惠侨科,广州510515

出　　处：《第一军医大学学报》1999年第6期547-549,共3页Journal of First Military Medical University

基　　金：诺华器官移植基金资助!(76 40374)

摘　　要：目的探讨群体反应性抗体 (PRA)配型新技术对肾移植近远期的效果。方法 85 4例患者肾移植前运用PRA新技术进行组织配型 ,并行血浆置换 ,未采用PRA组织配型的 42 3例作为对照 ,观察肾移植术后免疫指标变化、近期 (AR)发生率以及对长期存活的影响。结果未采用PRA组织配型组发生超急性排斥反应 (HR) 9例 (2 1% )、急性排斥反应 198例 (47% ) ;1年人/肾存活率 86 7% /76 3%、3年人 /肾存活率 72 5 % /6 7 9%、5年人 /肾存活率 6 9 5 % /4 9 3%。采用PRA配型新技术共 85 4例 ,肾移植术后未发生超急性排斥反应 ,发生急性排斥反应 16 2例 (19 0 % ) ,1年人肾存活率达 97 3% /95 0 %、3年人肾存活率 92 0 % /84 2 %、5年人 /肾存活率 87 0 % /81 6 %。结论PRA阴性配型可杜绝超急性排斥反应发生 ,降低急性排斥反应发生率 ,提高人 /肾长期存活率。Objective To evaluate the short-term and long-term result of histocompatibility examination of panel reactive antibody (PRA) before renal transplantation Methods PRA histocompatibility examination was performed in 854 patients before kidney transplantation, who were either PRA negative or PRA positive and underwent plasma exchange Four hunared and twenty-three patients not receiving PRA served as control The changes of immune variables, the ratio of acute rejection and the long-term survival rate were observed Results In control group, hyper-acute rejection occurred in 9 patients (2 1%), acute rejection in 198 patients (47%), and the patient/kidney survival rates were 86 7%/76 3% (for 1 year), 72 5%/67 9% (for 3 years) and 69 5%/49 3% (for 5 years), respectively In PRA group, no hyper-acute rejection occurred, and acute rejection was observed in 162 patients (19 0%), and the patient/kidney survival rates were 97 3%/95 0% (for 1 year), 92 0%/84 2% (for 3 years) and 87 0%/81 6% (for 5 years), respectively Conclusions Negative result of PRA examination before renal transplantation can eliminate hyper-acute rejection, decrease the ratio of acute rejection and improve patient/kidney survival rate

关 键 词：肾移植 PRA配型技术 排斥反应 

分 类 号：R699.2[医药卫生—泌尿科学] R392.4[医药卫生—外科学]