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100例人类白细胞抗原(HLA)配型相同的同胞移植。组织相容性以外的预后因素。

100 HLA-identical sibling transplants. Prognostic factors other than histocompatibility.

作者信息

Ascher N L, Simmons R L, Noreen H, VanHook J, Howard R J, Sutherland D E, Najarian J S

出版信息

Ann Surg. 1979 Feb;189(2):209-16. doi: 10.1097/00000658-197902000-00013.

Abstract

Analysis of 100 patients receiving HLA identical sibling transplants was performed. Excellent graft survival demonstrated in the group attests to the importance of matching serological determined antigens. There seems to be a modest beneficial effect on antilymphoblast globulin in low dosage, but not in high doses. Insulin dependent diabetes mellitus results in a significant negative influence on patient survival and graft function in the male recipient but not in the female. A particularly striking point that emerges is the potential hazard in incorrectly treating for rejection. Rejection occurs very rarely in these patients; in a patient with deteriorating renal function, etiologies other than rejection should be vigorously sought (including transcutaneous biopsy) prior to initiation of rejection therapy.

摘要

对100例接受 HLA 同型同胞移植的患者进行了分析。该组患者出色的移植物存活率证明了匹配血清学确定抗原的重要性。低剂量抗淋巴细胞球蛋白似乎有适度的有益作用,但高剂量则不然。胰岛素依赖型糖尿病对男性受者的患者存活率和移植物功能有显著负面影响,但对女性则无影响。一个特别突出的问题是错误治疗排斥反应的潜在危害。这些患者很少发生排斥反应;对于肾功能恶化的患者,在开始排斥反应治疗之前,应积极寻找除排斥反应之外的其他病因(包括经皮活检)。

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Renal transplantation in high-risk patients.
Arch Surg. 1971 Aug;103(2):290-8. doi: 10.1001/archsurg.1971.01350080206032.
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The HL-A system. Genetic and biological implications.组织相容性-白细胞抗原系统。遗传学及生物学意义。
Acta Pathol Microbiol Scand B Microbiol Immunol. 1970;78(5):529-46. doi: 10.1111/j.1699-0463.1970.tb04338.x.
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The clinical use of antilymphocyte globulin.抗淋巴细胞球蛋白的临床应用。
N Engl J Med. 1971 Jul 15;285(3):158-66. doi: 10.1056/NEJM197107152850310.
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Development of diabetic vascular lesions in normal kidneys transplanted into patients with diabetes mellitus.
N Engl J Med. 1976 Oct 21;295(17):916-20. doi: 10.1056/NEJM197610212951703.

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