Iqbal M M, Hossain R M, Rashid H U, Rahman M H, Datta M, Hassan M S
Department of Nephrology, SSMC&MH, Dhaka, Bangladesh.
Transplant Proc. 2006 Sep;38(7):2012-3. doi: 10.1016/j.transproceed.2006.06.036.
HLA antigen matching often plays an important role in organ transplantation. As for HLA class I antigen matching, there are differences of opinion regarding its influence on the outcome of renal transplantations. The aim of this study was to evaluate the association of HLA class I antigen matching with early graft outcomes in living donor kidney transplantation.
We evaluated graft outcomes in the first month of transplantation. Major events were slow graft function (serum creatinine > 250 micromol/L at the end of first week), delayed graft function (patients requiring dialysis in first week), and acute rejection episode. Graft outcomes were compared for normal renal function (NRF, serum creatinine < or = 175 micromol/L) impaired renal function (IRF, serum creatinine > 175 micromol/L) or impaired graft function due to an acute rejection episode (IGF).
The 115 subjects had a mean age of 29 +/- 8 years and their donors 38 +/- 11 years (P < .01). Immunosuppression included prednisolone, azathioprine, and cyclosporine. Parents, siblings, and others were kidney donors in 46%, 33%, and 21%, respectively. Comparisons between NRF/IRF (serum creatinine 133 +/- 24 vs 201 +/- 36 micromol/L, P < .01) and NGF/IGF (serum creatinine 146 +/- 44 vs 161 +/- 39 micromol/L, P < .05) showed no difference in number or pattern of HLA matching.
HLA class I antigen matching may not produce an added influence on early graft outcome among living donor kidney transplantations.
HLA抗原匹配在器官移植中常常发挥重要作用。至于HLA I类抗原匹配，关于其对肾移植结果的影响存在不同观点。本研究的目的是评估HLA I类抗原匹配与活体供肾移植早期移植物结果之间的关联。
我们评估了移植后第一个月的移植物结果。主要事件包括移植肾功能缓慢（第一周末血清肌酐>250微摩尔/升）、移植肾功能延迟（第一周需要透析的患者）和急性排斥反应。比较了肾功能正常（NRF，血清肌酐≤175微摩尔/升）、肾功能受损（IRF，血清肌酐>175微摩尔/升）或因急性排斥反应导致移植物功能受损（IGF）的移植物结果。
115名受试者的平均年龄为29±8岁，其供体的平均年龄为38±11岁（P<.01）。免疫抑制包括泼尼松龙、硫唑嘌呤和环孢素。父母、兄弟姐妹和其他亲属分别占肾供体的46%、33%和21%。NRF/IRF（血清肌酐133±24与201±36微摩尔/升，P<.01）和NGF/IGF（血清肌酐146±44与161±39微摩尔/升，P<.05）之间的比较显示，HLA匹配的数量或模式没有差异。
HLA I类抗原匹配可能不会对活体供肾移植的早期移植物结果产生额外影响。
