第14届国际人类白细胞抗原与免疫遗传学研讨会前瞻性慢性排斥反应项目：三年随访分析

14th International HLA and Immunogenetics Workshop Prospective Chronic Rejection Project: a three-year follow-up analysis.

作者信息

Ozawa M, Terasaki P I, Castro R, Alberu J, Morales-Buenrostro L, Alvarez I, Toledo R, Alvez H, Monteiro M, Teixeira J, Campbell P, Ciszek M, Charron D, Gautreau C, Christiansen F, Langan L, Conca R, Grosse-Wilde H, Heinemann F, Kamoun M, Kobayashi T, Kupatawintu P, LeFor W, Mehra N, Panigrahi A, Norman D, Piazza A, Poli F, Roy R, Schonemann C, Lachmann N, Sireci G, Tanabe K, Ishida H, Van den Berg-Loonen E, Zeevi A

机构信息

One Lambda, Inc., Los Angeles, CA, USA.

出版信息

Clin Transpl. 2007:255-60.

PMID:18642456

Abstract

The three-year follow-up of 4,144 patients of the 14th International Workshop Prospective Chronic Rejection study has reinforced the evidence that post-transplant HLA antibodies are predictive of long-term graft loss. Three years after a single testing for HLA antibodies, 10% of kidney recipients who were antibody-positive had lost their grafts, in contrast to only 5% of antibody-negative patients (p<0.0001). The adverse effect of post-transplant antibodies on graft survival was also observed in lung, heart, and liver transplants. Donor-specific antibodies and 'strong' non-DSA had stronger association with graft loss than 'moderate' non-DSA. Periodic antibody monitoring, combined with specificity and strength analysis, would help in the early identification of allograft recipients who are at high risk of graft failure.

摘要

第14届国际研讨会前瞻性慢性排斥反应研究中4144例患者的三年随访进一步证实，移植后HLA抗体可预测长期移植物丢失。在进行一次HLA抗体检测三年后，抗体阳性的肾移植受者中有10%失去了移植物，而抗体阴性患者中这一比例仅为5%（p<0.0001）。在肺、心脏和肝移植中也观察到移植后抗体对移植物存活的不良影响。供者特异性抗体和“强”非供者特异性抗体与移植物丢失的关联比“中度”非供者特异性抗体更强。定期进行抗体监测，并结合特异性和强度分析，将有助于早期识别有移植物失败高风险的同种异体移植受者。