Cheigh J S, Chami J, Stenzel K H, Riggio R R, Saal S, Mouradian J A, Fotino M, Stubenbord W T, Rubin A L
N Engl J Med. 1977 May 5;296(18):1030-4. doi: 10.1056/NEJM197705052961803.
We compared 26 HLA-A, B identical sibling kidney-transplant recipients followed for one to 10 years, with 104 HLA-A, B semi-identical kidney recipients from living, related donors to determine clinical differences. Graft-survival rates were significantly better in the HLA identical group at two years (85 per cent identical versus 53 per cent in semi-identical, P less than 0.005); patient-survival rates were high for both (96 per cent in identical and 87 per cent in semi-identical at two years, P less than 0.005). The incidence of complications was similar in HLA identical and semi-identical recipients. Nine of the 26 grafts in HLA identical recipients failed one week to eight years after transplantation. Rejection caused most of the graft failures. Recipients of HLA identical-sibling kidney transplants have a high patient and graft survival, but they also encounter many complications. Immunologic rejection occurs, even with negative mixed lymphocyte culture, suggesting the importance of donor determinants other than the HLAA, B and D other than the HLA-A, B and D.
我们比较了26名随访1至10年的HLA - A、B相同的同胞肾移植受者与104名来自活体亲属供者的HLA - A、B半相同的肾移植受者，以确定临床差异。HLA相同组的移植物存活率在两年时显著更高（85%相同组对53%半相同组，P小于0.005）；两组的患者存活率都很高（两年时相同组为96%，半相同组为87%，P小于0.005）。HLA相同和半相同受者的并发症发生率相似。HLA相同受者的26个移植物中有9个在移植后1周至8年失败。排斥反应是大多数移植物失败的原因。HLA相同同胞肾移植受者有较高的患者和移植物存活率，但他们也会遇到许多并发症。即使混合淋巴细胞培养为阴性，免疫排斥反应仍会发生，这表明除了HLA - A、B和D之外，供者决定簇也很重要。
