Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
Transplantation. 2011 Jul 27;92(2):163-9. doi: 10.1097/TP.0b013e318222c9a0.
Acute rejection after renal transplantation has been shown to be negatively associated with long-term graft survival. Identifying donor factors that are associated with acute rejection in the recipient could help to a better understanding of the relevant underlying processes that lead to graft injury. Complement activation has been shown to be an important mediator of renal transplant related injury. In this study, we analyzed the effect of systemic complement activation in deceased donors before transplantation of their kidneys on posttransplant outcome in the recipient.
Plasma from 232 deceased brain-dead and deceased cardiac-dead donors were analyzed for the complement activation markers C5b-9, C4d, Bb, and complement component mannan binding lectin by ELISA. The association of these parameters with posttransplant outcome in recipients was analyzed in a multivariate regression model.
It was found that C5b-9 level in donor plasma is associated with biopsy-proven acute rejection in the recipient during the first year after renal transplantation (P = 0.035). Both in deceased brain-dead and deceased cardiac-dead donors increased complement activation was found.
In conclusion, we found C5b-9 in the donor to be associated with acute rejection of renal transplants in the recipient. Whether targeting complement activation in the donor may ameliorate acute rejection in the recipient needs to be studied.
肾移植后的急性排斥反应已被证明与长期移植物存活率呈负相关。确定与受者急性排斥反应相关的供者因素有助于更好地了解导致移植物损伤的相关潜在过程。补体激活已被证明是肾移植相关损伤的重要介质。在这项研究中，我们分析了 232 例脑死亡和心死亡供者在移植前其肾脏的系统性补体激活标志物 C5b-9、C4d、Bb 和补体成分甘露聚糖结合凝集素的血浆水平，通过 ELISA 进行分析。在多变量回归模型中分析了这些参数与受者移植后结局的关系。
发现供者血浆中的 C5b-9 水平与肾移植后 1 年内受者活检证实的急性排斥反应有关（P=0.035）。在脑死亡和心死亡供者中均发现补体激活增加。
总之，我们发现供者的 C5b-9 与受者的肾移植急性排斥反应有关。是否可以通过靶向供者的补体激活来减轻受者的急性排斥反应，仍需要进一步研究。
