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微嵌合现象与肾移植:疑问依然存在。

Microchimerism and renal transplantation: doubt still persists.

作者信息

Saraji A, Pourmand G, Mehrsai A, Taherimahmodi M, Nikoobakht M, Asadpour A, Nikbin B, Tajik N, Emamzadeh A

机构信息

Urology Research Center, Kidney Transplantation Unit, Tehran, Iran.

出版信息

Transplant Proc. 2007 May;39(4):948-50. doi: 10.1016/j.transproceed.2007.03.082.

Abstract

OBJECTIVE

We sought to study microchimerism in a group of kidney transplant recipients.

MATERIALS AND METHODS

In this study, the peripheral blood microchimerism (PBM) after renal transplantation was retrospectively evaluated in 32 male-to-female recipients of living unrelated or cadaveric donor renal transplants. Using a nested polymerase chain reaction (PCR) amplification specific for SRY region of the Y chromosome, microchimerism was detected with a sensitivity of 1:1,000,000. Recipients were compared according to the presence of PBM, acute and chronic rejection episodes, type of allotransplant, recipient and donor age at transplantation, previous male labor or blood transfusion, allograft function (serum creatinine level), and body mass index.

RESULTS

Among 32 recipients, 7 (21.9%) were positive for PBM upon multiple testing at various posttransplant times. All microchimeric recipients had received kidneys from living unrelated donors. No significant difference was observed with regard to other parameters. In addition the acute rejection rate in the microchimeric group was 3 (42%) versus 4 (16%) in the nonmicrochimeric recipients (not significant).

CONCLUSION

Our results suggested better establishment of microchimerism after living donor kidney transplantation. However, doubt persists concerning the true effect of microchimerism after renal transplantation. It seems that microchimerism alone has no major protective role upon renal allograft survival.

摘要

目的

我们试图研究一组肾移植受者中的微嵌合体现象。

材料与方法

在本研究中,对32例接受活体非亲属或尸体供肾移植的男性供体至女性受体的肾移植术后外周血微嵌合体(PBM)进行回顾性评估。使用针对Y染色体SRY区域的巢式聚合酶链反应(PCR)扩增,以1:1,000,000的灵敏度检测微嵌合体。根据PBM的存在情况、急性和慢性排斥反应发作、同种异体移植类型、移植时受体和供体年龄、既往男性劳动或输血情况、同种异体移植功能(血清肌酐水平)和体重指数对受者进行比较。

结果

在32例受者中,7例(21.9%)在移植后不同时间的多次检测中PBM呈阳性。所有微嵌合体受者均接受了活体非亲属供体的肾脏。在其他参数方面未观察到显著差异。此外,微嵌合体组的急性排斥率为3例(42%),而非微嵌合体受者为4例(16%)(无显著性差异)。

结论

我们的结果表明活体供肾移植后微嵌合体形成情况较好。然而,肾移植后微嵌合体的真正作用仍存在疑问。似乎单纯微嵌合体对同种异体肾移植存活没有主要保护作用。

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