Matinlauri I H, Nurminen M M, Höckerstedt K A, Isoniemi H M
Department of Clinical Chemistry, Kuopio University Hospital, Kuopio, Finland.
Transplant Proc. 2006 Oct;38(8):2663-6. doi: 10.1016/j.transproceed.2006.07.032.
Incidence and possible risk factors of acute rejection, time to acute rejection, graft rejection within 3 months, multiple rejections within 1 year, steroid-resistant rejection, and graft lost to chronic rejection or to chronic dysfunction were evaluated in 388 liver transplantations. HLA matches, anti-HLA class I antibodies, positive crossmatch test, or positive cytomegalovirus serology did not have an effect on the occurrence of acute or chronic rejection. Increased total bleeding diminished occurrence of acute rejection, lengthened the time to acute rejection, and reduced the risk of steroid-resistant rejection. Immunological pretransplant factors did not have a major effect on the occurrence of rejection after liver transplantation. Different types of rejections diminished over time and the time period to the first acute rejection increased, although the basic immunosuppression stayed mainly the same over 20 years in our center.
在388例肝移植中，对急性排斥反应的发生率及可能的危险因素、急性排斥反应发生时间、3个月内的移植排斥反应、1年内的多次排斥反应、激素抵抗性排斥反应以及因慢性排斥反应或慢性功能障碍导致的移植肝丢失情况进行了评估。人类白细胞抗原（HLA）匹配、抗HLA I类抗体、交叉配型试验阳性或巨细胞病毒血清学阳性对急性或慢性排斥反应的发生没有影响。总出血量增加可减少急性排斥反应的发生，延长急性排斥反应发生时间，并降低激素抵抗性排斥反应的风险。移植前的免疫因素对肝移植后排斥反应的发生没有重大影响。尽管在我们中心20多年来基本免疫抑制方案基本相同，但不同类型的排斥反应随时间减少，首次急性排斥反应的时间间隔增加。
