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活体亲属肾移植中抗人类白细胞抗原及抗主要组织相容性复合体I类相关链A抗体的监测

Monitoring of anti-HLA and anti-Major histocompatibility complex class I related chain A antibodies in living related renal donor transplantation.

作者信息

Panigrahi A, Gupta N, Siddiqui J A, Margoob A, Bhowmik D, Guleria S, Mehra N K

机构信息

Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Transplant Proc. 2007 Apr;39(3):759-60. doi: 10.1016/j.transproceed.2007.02.009.

Abstract

This study was undertaken with the aim to analyze the clinical relevance of posttransplant anti-HLA and anti-major histocompatibility complex class I related chain A (MICA) antibodies in response to living related donor renal transplantation. A total of 185 consecutive post-renal transplant recipient serum samples were analyzed for the detection of anti-HLA and MICA antibodies using enzyme-linked immunosolvent assay techniques. Patients carrying both anti-HLA as well as anti-MICA antibodies (MICA(+)/HLA(+)) were the worst affected, showing significantly poorer graft survival compared with the MICA-/HLA-negative group (17% vs 89%, chi(2) = 19.63, P = .000). Similarly, patients with only MICA antibodies or those with only HLA antibodies also had significantly lower graft survival (P = .035 and P = .001, respectively) as compared to the nonsensitized group. The study illustrated that posttransplant monitoring antibodies to both MICA as well as HLA could be good predictors of renal allograft failure.

摘要

本研究旨在分析肾移植术后抗人白细胞抗原(HLA)抗体和抗主要组织相容性复合体I类相关链A(MICA)抗体与亲属活体供肾移植反应的临床相关性。采用酶联免疫吸附测定技术,对185例连续性肾移植受者的血清样本进行分析,以检测抗HLA和MICA抗体。同时携带抗HLA和抗MICA抗体(MICA(+)/HLA(+))的患者受影响最严重,与MICA-/HLA阴性组相比,其移植肾存活率显著更低(17%对89%,χ² = 19.63,P = 0.000)。同样,仅携带MICA抗体或仅携带HLA抗体的患者与未致敏组相比,移植肾存活率也显著更低(分别为P = 0.035和P = 0.001)。该研究表明,肾移植术后监测MICA和HLA抗体可能是预测同种异体肾移植失败的良好指标。

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