Institute of Organ Transplantation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China; Key Laboratory of Organ Transplantation, Ministry of Public Health, Wuhan, China.
Institute of Organ Transplantation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
J Immunol Res. 2016;2016:2697860. doi: 10.1155/2016/2697860. Epub 2016 Dec 8.
It has been reported that kidney retransplant patients had high rates of early acute rejection due to previous sensitization. In addition to the acute antibody-mediated rejection (ABMR) that has received widespread attention, the early acute T-cell-mediated rejection (TCMR) may be another important issue in renal retransplantation. In the current single-center retrospective study, we included 33 retransplant patients and 90 first transplant patients with similar protocols of induction and maintenance therapy. Analysis focused particularly on the incidence and patterns of early acute rejection episodes, as well as one-year graft and patient survival. Excellent short-term clinical outcomes were obtained in both groups, with one-year graft and patient survival rates of 93.9%/100% in the retransplant group and 92.2%/95.6% in the first transplant group. Impressively, with our strict immunological selection and desensitization criteria, the retransplant patients had a very low incidence of early acute ABMR (6.1%), which was similar to that in the first transplant patients (4.4%). However, a much higher rate of early acute TCMR was observed in the retransplant group than in the first transplant group (30.3% versus 5.6%, < 0.001). Acute TCMR that develops early after retransplantation should be monitored in order to obtain better transplant outcomes.
据报道，由于先前的致敏作用，肾再移植患者早期急性排斥反应的发生率较高。除了广泛关注的急性抗体介导的排斥反应（ABMR）外，早期急性 T 细胞介导的排斥反应（TCMR）可能是肾再移植的另一个重要问题。在目前的单中心回顾性研究中，我们纳入了 33 例再移植患者和 90 例具有相似诱导和维持治疗方案的首次移植患者。分析特别关注了早期急性排斥反应发作的发生率和模式，以及 1 年移植物和患者的存活率。两组均获得了良好的短期临床结局，再移植组和首次移植组的 1 年移植物和患者存活率分别为 93.9%/100%和 92.2%/95.6%。令人印象深刻的是，通过我们严格的免疫选择和脱敏标准，再移植患者的早期急性 ABMR 发生率非常低（6.1%），与首次移植患者相似（4.4%）。然而，再移植组早期急性 TCMR 的发生率明显高于首次移植组（30.3%比 5.6%，<0.001）。应该监测再移植后早期发生的急性 TCMR，以获得更好的移植结局。
