Ringdén O, Berg B
Tissue Antigens. 1977 Nov;10(5):364-72. doi: 10.1111/j.1399-0039.1977.tb00772.x.
The role of HLA-A and-B and HLA-D compatibility was analyzed in 63 recipients of intrafamilial kidney grafts. At 1 year post-transplantation the survival of grafts from HLA-A and-B compatible donors was 89% and that of grafts from HLA-A and/or-B incompatible donors 77%. Recipents with a Relative Response (RR) in MLC of less than 20% towards their donors, indicating HLA-D compatibility, had a 4-year graft survival of 100%. After 1 year the graft survival of this group was statistically different (p less 0-01) from the 63% graft survival of recipients with an RR greater than 60%. An RR greater than 60% indicates HLA-D incompatibility between recipient and donor. For patients with RR less than 60% the 2-year graft survival was 46%. This was lower than that of patients with RR less than 20% (P less than 0.001) and that of patients with an RR of 20--60% (P less than 0.01). The recipients with an RR of 20--60%, indicating slight HLA-D incompatibility with their donors, had a 2-year graft survival of 88%. We concluded that graft survival was correlated to the magnitude of MLC response between recipients and donors in such a way that a high MLC response indicating HLA-D incompatibility was associated with a high frequency of graft rejection while a low MLC response was associated with graft survival. HLA-D compatibility correlated with an excellent outcome in five cases in spite of HLA-A and-B incompatibility.
对63例接受家族内肾移植的受者，分析了HLA - A和 - B以及HLA - D相容性的作用。移植后1年，来自HLA - A和 - B相容供者的移植物存活率为89%，而来自HLA - A和/或 - B不相容供者的移植物存活率为77%。混合淋巴细胞培养（MLC）中对供者相对反应（RR）低于20%的受者，表明HLA - D相容，其4年移植物存活率为100%。1年后，该组移植物存活率与RR大于60%的受者63%的移植物存活率在统计学上有差异（p小于0.01）。RR大于60%表明受者与供者之间HLA - D不相容。对于RR小于60%的患者，2年移植物存活率为46%。这低于RR小于20%的患者（P小于0.001）以及RR为20 - 60%的患者（P小于0.01）。RR为20 - 60%的受者，表明与供者存在轻微的HLA - D不相容，其2年移植物存活率为88%。我们得出结论，移植物存活率与受者和供者之间MLC反应的强度相关，即表明HLA - D不相容的高MLC反应与高频率的移植排斥相关，而低MLC反应与移植物存活相关。尽管存在HLA - A和 - B不相容，但HLA - D相容在5例中与良好的结果相关。
