初始血型抗体效价对ABO不相合肾移植的影响  

The initial anti-A/B antibody titer on clinical outcomes of ABO incompatible kidney transplant recipients

作　　者：王显丁[1] 徐子林 刘金鹏[1] 吕远航 邱阳[1] 宋涂润[1] 蒋亚梅 范钰[1] 黄春妍[2] 王莉[1] 林涛[1] WANG Xianding;XU Zilin;LIU Jinpeng;LV Yuanhang;QIU Yang;SONG Turun;JIANG Yamei;FAN Yu;HUANG Chunyan;WANG Li;LIN Tao(Department of Urology/Institute of Urology/Organ Transplantation Center,West China Hospital,Sichuan University, Chengdu 610041,China;Department of Laboratory Medicine,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院泌尿外科泌尿外科研究所器官移植中心,成都610041 [2]四川大学华西医院实验医学科,成都610041

出　　处：《肾脏病与透析肾移植杂志》2018年第6期544-548,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：国家自然科学基金面上项目(81470980;81870513;81600584);四川大学青年教师科研启动基金(2017SCU11022);四川大学华西医院学科卓越发展1.3.5工程临床研究孵化项目

摘　　要：目的:探讨初始血型抗体效价水平对ABO血型不相合活体肾移植临床结局的影响。方法:本研究纳入2014年9月至2017年11月在四川大学华西医院接受ABO血型不相合活体肾移植的40对供、受者。根据受者初始ABO血型抗体效价水平,将纳入的受者分为两组:低抗体效价组(n=18例)和高抗体效价组(n=22例),比较两组供、受者的基线特征、血型抗体效价变化和肾移植临床结局。结果:两组受者中位随访时间20个月(3～42)。所有受者在移植后2周内血型抗体效价均不超过1∶16。低效价和高效价组受者1年移植肾及受者存活率分别为94. 4%vs 95. 5%和100%vs 100%(P均>0. 05),每组均有1例受者发生超急性排斥反应致移植肾失功。两组受者术后2年内的血清肌酐水平和估算的肾小球滤过率无显著差异,急性排斥反应、感染、血糖血脂代谢水平及伤口液化的发生率也没有显著差异。结论:初始血型抗体水平并不影响ABO血型不相合肾移植的临床结局。Objective: To investigate the impact of initial anti-A/B antibody titer on clinical outcomes in ABOincompatible living donor kidney transplantation. Methodology: A series of forty ABO-incompatible living kidney transplant recipients between September 2014 to November 2017 in West China Hospital were included in this study.According to initial anti-A/B antibody titer,recipients were divided into low-antibody group( titer≤1 ∶ 16)( n = 18) and high-antibody group( n = 22)( titer > 1 ∶ 16). The baseline characteristics,change of antibody titer and clinical outcomes between both groups were compared. Results: The rebound of A/B antibody titer within 2 weeks after transplantation in all recipients was not more than 1 ∶ 16.The median follow-up time was 20( 3 ~ 42) months.There was no significant difference in the serum creatinine and e GFR of recipients in two years after transplantation between both groups( P>0. 05).The one-year graft and patient survival in low-antibody group and high-antibody group were 94. 4% vs 95. 5%,and 100% vs 100%,respectively( P>0. 05). And one patient suffered from graft loss in each group because of hyperacute rejection. The incidence of rejection,infection,blood glucose and lipid metabolism,and the fatty liquefaction in wound were comparable between both groups( P > 0. 05). Conclusion: Our data suggests the initial anti-A/B antibody titer has no effect on outcomes of ABO-incompatible kidney transplantation.

关 键 词：初始血型抗体效价 ABO血型不相合 活体肾移植 个体化预处理 

分 类 号：R699.2[医药卫生—泌尿科学]