Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
Transpl Int. 2011 Feb;24(2):150-7. doi: 10.1111/j.1432-2277.2010.01166.x. Epub 2010 Sep 9.
In this study, we retrospectively investigated the relationship between the presence/titers of donor-specific (DSA)/nondonor-specific antibody (NDSA) and the rate of graft rejection after transplantation. The subjects comprised 34 recipients who tested positive by FlowPRA(®) Screening. The recipients were divided into two groups; 22 recipients with DSA and 12 recipients with NDSA, as detected using FlowPRA(®) Single Antigen I and II beads. The antibodies were also quantitatively examined using the molecules of equivalent soluble fluorochrome (MESF) method. Nine of the 22 recipients with DSA (9/22, 40%) developed antibody-mediated rejection (AMR), while none of the 12 recipients with NDSA (0/12, 0%) developed AMR (P < 0.01). In a quantitative analysis of the MESF data, patients with DSA with MESF values of over 3000 frequently showed AMR (8/11, 73%). In contrast, one of the patients with DSA with MESF values of <3000 showed AMR (1/11, 9%). One of the 12 patients (1/12, 8%) with NDSA showed cellular rejection (T-cell-mediated rejection), regardless of the MESF values. In patients with DSA, an MESF value of 3000 may be a useful cutoff value for identifying patients at a high risk for AMR.
在这项研究中，我们回顾性地研究了供体特异性（DSA）/非供体特异性抗体（NDSA）的存在/滴度与移植后排斥反应发生率之间的关系。研究对象包括 34 名通过 FlowPRA(®)Screening 检测呈阳性的受者。受者分为两组：22 名有 DSA 的受者和 12 名有 NDSA 的受者，使用 FlowPRA(®)Single Antigen I 和 II 珠粒检测到。使用分子等效可溶性荧光染料（MESF）法也定量检查了抗体。22 名有 DSA 的受者中有 9 名（9/22，40%）发生了抗体介导的排斥反应（AMR），而 12 名有 NDSA 的受者中无一例发生 AMR（P<0.01）。在 MESF 数据的定量分析中，MESF 值超过 3000 的 DSA 患者经常出现 AMR（8/11，73%）。相比之下，MESF 值<3000 的 DSA 患者中有 1 例发生 AMR（1/11，9%）。12 名有 NDSA 的患者中有 1 名（1/12，8%）发生细胞排斥（T 细胞介导的排斥），无论 MESF 值如何。在 DSA 患者中，MESF 值 3000 可能是识别 AMR 高风险患者的有用临界值。
