多供体脐血输注诱导免疫低反应性的研究  

Study of immunological hyporesponsiveness induced by multiple cord blood transfusions

作　　者：赵鲁平[1] 王莉[1] 杨宇如[1] 卢一平[1] 代波[1] 唐科士[1] 

机构地区：[1]四川大学华西医院泌尿外科,成都610041

出　　处：《中华器官移植杂志》2002年第2期69-71,共3页Chinese Journal of Organ Transplantation

摘　　要：目的　通过多供体脐血输注诱导肾移植术前患者产生同种免疫低反应性。方法　选取终末期尿毒症拟行肾移植的患者 39例 ,2 0例接受多供体脐血输注 (脐血组 ) ,1 9例接受成人外周血洗涤红细胞输注 (对照组 )。分别于输血前 (T0 )、输血后 1个月 (T1 )、2个月 (T2 )、3个月 (T3)及移植术前后动态监测受者混合淋巴细胞培养 (MLC)以及血清HLA同种抗体水平的变化。结果　脐血组输血后 1、2、3个月受者淋巴细胞对供脐血淋巴细胞及无关成人淋巴细胞的MLC明显下降。脐血组自身前后对照MLC受抑制率可达 70 %以上 ;与对照组比较 ,差异有显著性 (P <0 .0 5)。脐血组移植术前后受者淋巴细胞对供肾淋巴细胞的MLC亦受到明显抑制 ,和对照组比较 ,差异有显著性。脐血组输血后血清同种反应抗体水平亦显著下降。 7例输血前同种抗体呈阳性反应者 ,输血后 6例转为阴性 ,1例有明显下降 ;而对照组输血前 4例抗体阳性者无 1例下降或转阴。结论　多供体脐血输注能够诱导受者淋巴细胞对供脐血淋巴细胞的特异性免疫低反应性 ,这一低反应性还可“非特异”Objective To induce immunological hyporesponsivness by multiple cord blood transfusions in patients waiting for renal transplantation.Methods Of 39 patients with end stage renal failure, 20 were transfused with multiple cord blood (cord blood group) and the remaining 19 were treated with buffy coat depleted blood (control group). The changes of MLC and serological HLA antibodies in the recipients were observed before blood transfusions (T0), one month (T1), two months (T2) and three months (T3) after transfusions, respectively.Results The MLC in cord blood group was inhibited significantly ( P < 0.05 ). The levels of HLA Ⅰ, Ⅱ antibodies were reduced obviously after transfusions. Of the 7 patients positive for HLA Ⅰ, Ⅱ antibodies before transfusions in cord blood group, 6 were negative for HLA Ⅰ, Ⅱ antibodies and 1 reduced after transfusions. However, in the control group none of 4 patients positive for the antibodies before transfusions turned to negative 3 months after transfusions.Conclusion Cord blood transfusion can induce immunological hyporesponsiveness.

关 键 词：移植预处理 肾移植 术前 多供体 脐血输注 免疫低反应性 

分 类 号：R457.7[医药卫生—治疗学]