Chen Wei, Chen Gui-hua, Lu Min-qiang, Yang Yang, Cai Chang-jie, Hou Bao-hua, Lin Ye, Zhang Wei-dong, Xiao Lu-lu
Department of Hepatobiliary Surgery, People's Hospital of Guangdong Province, Guangzhou 510080, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2006 Jun;26(6):774-6.
To evaluate the effect of perioperative HLA antibody changes on acute allograft rejection in cadaveric liver transplantation.
Totally 134 patients received modified piggyback liver transplantation and enzyme-linked immunosorbent assay was performed for HLA antibody detection before and the 1, 7, 14 and 30 days after operation. B ultrasound-guided liver biopsy was employed for diagnosis of acute allograft rejection, and the perioperative changes of HLA antibodies were evaluated for their effect on allograft acute rejection.
Of the 44 recipients with preoperative positivity for HLA antibodies, acute rejection occurred in 56.8% of the patients, as compared with 25.9% in those negative for HLA antibody (P=0.001). The patients who became positive for HLA antibody postoperatively had a rate of acute rejection of 60%, which was significantly higher than that in those persistently negative for HLA antibody (18.6%, P=0.003).
HLA antibody positivity before transplantation may contribute to acute rejection episode in liver transplantation, and persistent posttransplant HLA antibody positivity is closely associated with the occurrence of acute rejection.
评估尸体肝移植围手术期人类白细胞抗原（HLA）抗体变化对急性移植物排斥反应的影响。
134例患者接受改良背驮式肝移植，于术前及术后1天、7天、14天和30天采用酶联免疫吸附试验检测HLA抗体。采用B超引导下肝穿刺活检诊断急性移植物排斥反应，评估围手术期HLA抗体变化对移植物急性排斥反应的影响。
术前HLA抗体阳性的44例受者中，急性排斥反应发生率为56.8%，而HLA抗体阴性者为25.9%（P = 0.001）。术后HLA抗体转为阳性的患者急性排斥反应发生率为60%，显著高于HLA抗体持续阴性者（18.6%，P = 0.003）。
移植前HLA抗体阳性可能导致肝移植急性排斥反应的发生，移植后HLA抗体持续阳性与急性排斥反应的发生密切相关。
