HLA - DR抗原与急性类固醇抵抗性排斥反应及肾移植存活率低下的关联。

The association of HLA-DR antigens with acute steroid-resistant rejection and poor kidney graft survival.

作者信息

Salmela K, von Willebrand E, Kyllönen L, Koskimies S, Isoniemi H, Eklund B, Höckerstedt K, Ahonen J

机构信息

Department of Surgery IV, Helsinki University Central Hospital, Finland.

出版信息

Transplantation. 1991 Apr;51(4):768-71. doi: 10.1097/00007890-199104000-00006.

DOI:10.1097/00007890-199104000-00006

PMID:2014528

Abstract

The association of an early steroid-resistant rejection (SRR) with HLA-DR antigens was analyzed in 410 kidney transplantations. A severe SRR leading to a poor (45%) 1-year graft survival (GS) occurred in 22 transplantations (5%). An acute reversible rejection (ARR) with a GS of 94% was found in 80 transplantations (20%). For the 308 (75%) transplantations with no early rejection episodes the GS was 91%. HLA-DR5 and -DR8 present in the donor as incompatible antigens were strongly associated with SRR. Further, a mismatched DR1 from the kidney donor predicted a rejection, either reversible or irreversible. These findings may have practical implications for an early diagnosis of SRR and for considering of rescue therapy whenever transplantation with disparities in these loci has been performed.

摘要

在410例肾移植中分析了早期类固醇抵抗性排斥反应（SRR）与HLA - DR抗原的关联。22例移植（5%）发生了严重的SRR，导致1年移植肾存活率（GS）较差（45%）。80例移植（20%）出现了急性可逆性排斥反应（ARR），其GS为94%。对于308例（75%）无早期排斥反应的移植，GS为91%。供体中作为不相容抗原存在的HLA - DR5和 - DR8与SRR密切相关。此外，来自肾供体的不匹配DR1预示着会发生排斥反应，无论是可逆的还是不可逆的。这些发现可能对SRR的早期诊断以及在这些基因座存在差异的移植后考虑采用挽救治疗具有实际意义。