日本某移植中心肺移植受者致敏比例。
The fraction of sensitization among lung transplant recipients in a transplant center in Japan.
机构信息
Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
Division of Organ Transplantation, Tohoku University Hospital, 4-1 Seiryomachi, Sendai, Miyagi, 980-8574, Japan.
出版信息
BMC Pulm Med. 2020 Oct 2;20(1):256. doi: 10.1186/s12890-020-01299-0.
BACKGROUND
Anti-human leukocyte antigen (HLA) antibody testing was approved by the Japanese government in 2018. As such, there was no longitudinal data regarding the HLA-sensitization of lung transplant (LTX) patients in Japan. We therefore set out to measure anti-HLA antibodies from all our LTX patients during their annual follow-up to characterize the sensitization status in the Japanese population.
METHODS
The cross-sectional study was conducted for consecutive LTX recipients who underwent transplantation from January 2000 to January 2020 at Tohoku University Hospital (TUH). The serum from the recipients was screened for anti-HLA antibody with the panel-reactive assay (PRA) and the donor-specific antibodies (DSA).
RESULTS
Sensitization was reviewed in 93 LTX recipients, showing 23 positive (24.7%) and 70 negative (75.3%) PRA. More sensitized recipients were found in recent transplantations (60.9% (14/23), ≤5 years post LTX) than in older transplantations (17.4% (4/23), 5-10 years or 21.7% (5/23), ≥10 years post LTX) (p = 0.04). Even fewer recipients had DSA (5.4%, 5/93), among whom 4/5 (80%) were recently transplanted.
CONCLUSION
The rate of PRA positive LTX recipients in our population was lower compared with those in previous reports from US and Europe. More sensitized LTRs were found in recent transplantations than the older cohort, and DSA was identified primarily in the recent recipients. Due to several limitations, it is still unclear whether the sensitization would be related the development of CLAD or survival, yet this study would be fundamental to the future anti-HLA body study in Japanese population.
背景
抗人类白细胞抗原（HLA）抗体检测于 2018 年获得日本政府批准。因此，日本尚无关于肺移植（LTX）患者 HLA 致敏的纵向数据。因此，我们着手测量所有 LTX 患者在年度随访期间的抗 HLA 抗体，以描述日本人群的致敏状况。
方法
这项横断面研究纳入了 2000 年 1 月至 2020 年 1 月期间在东北大学医院（TUH）接受移植的连续 LTX 受者。用群体反应性抗体检测（PRA）和供体特异性抗体（DSA）对受者的血清进行抗 HLA 抗体筛查。
结果
对 93 例 LTX 受者进行了致敏性回顾，其中 23 例 PRA 阳性（24.7%），70 例 PRA 阴性（75.3%）。在近期移植中发现更多致敏受者（60.9%（14/23），LTX 后≤5 年），而在较陈旧移植中发现较少致敏受者（17.4%（4/23），5-10 年或 21.7%（5/23），LTX 后≥10 年）（p=0.04）。有 DSA 的受者更少（5.4%，5/93），其中 5/5（80%）为近期移植。
结论
与来自美国和欧洲的先前报告相比，我们人群中 PRA 阳性 LTX 受者的比例较低。近期移植的受者中致敏受者较多，而 DSA 主要在近期受者中发现。由于存在多种局限性，尚不清楚致敏是否与 CLAD 或生存的发展有关，但这项研究将为日本人群中未来的抗 HLA 抗体研究奠定基础。
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