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CDC-XM和HLA相容性对肾移植受者术后恢复期临床结局的影响:一项回顾性分析。

Influence of CDC‑XM and HLA compatibility on clinical outcomes in kidney transplant recipients during the post‑operative recovery period: A retrospective analysis.

作者信息

Xie Siqi, Xu Chonghe, Zhu Zhongqi, Qin Chao, Song Xixi, Wang Xin, Xu Wei, Zhu Mei

机构信息

Department of Clinical Laboratory, The Affiliated Chaohu Hospital of Anhui Medical University, Chaohu, Anhui 238000, P.R. China.

School of Basic Medical Sciences, Capital Medical University, Beijing 100069, P.R. China.

出版信息

Exp Ther Med. 2025 Mar 19;29(5):99. doi: 10.3892/etm.2025.12849. eCollection 2025 May.

Abstract

Kidney transplantation remains the preferred treatment for patients with end-stage kidney failure. Complement-dependent cytotoxicity (CDC) crossmatch (CDC-XM) and human leukocyte antigen (HLA) typing are two important methods of donor-recipient matching prior to kidney transplantation. The purpose of the present study was to explore the effects of CDC-XM levels and HLA matching on early post-operative clinical outcomes in kidney transplant recipients. A total of 112 consecutive recipients who underwent allogeneic kidney transplantation were selected and their data collected, including pre-operative general information, indicators associated with renal function, red blood cell and white blood cell counts, the blood glucose level at each follow-up time point and both the incidence of adverse events following transplantation and their risk factors. During the follow-up period, statistical methods were used to compare and systematically analyze the differences in clinical indicators and adverse events between each groups. In each different groups that were assigned for the CDC-XM levels and HLA matching, the differences in the clinical indicators between the groups during the follow-up period were mainly centered on the first week post-transplantation, with the greatest differences being identified for the renal function-associated indicators, whereas the observed recovery was essentially comparable between 1-6 months. According to the multivariate analysis, recipients of age ≥40 years and with a BMI ≥25 tended to have an increased risk of delayed graft function (DGF), whereas the risk was reduced when the organ had been donated by a living donor and also when the number of HLA mismatches was 0-2. In conclusion, the present study showed that CDC-negativity and improved HLA matching help to promote the recovery of renal function in kidney transplant recipients during the early post-operative period. Patients who met the conditions of CDC-negativity and fewer HLA mismatches had faster and improved early postoperative recovery of renal function and a lower incidence of DGF. Furthermore, in a multifactorial analysis of DGF, recipient age, recipient BMI, donor type and HLA mismatch were found to be important risk factors for DGF.

摘要

肾移植仍然是终末期肾衰竭患者的首选治疗方法。补体依赖细胞毒性(CDC)交叉配型(CDC-XM)和人类白细胞抗原(HLA)分型是肾移植前供受者匹配的两种重要方法。本研究的目的是探讨CDC-XM水平和HLA匹配对肾移植受者术后早期临床结局的影响。选取112例连续接受同种异体肾移植的受者,收集其数据,包括术前一般信息、与肾功能相关的指标、红细胞和白细胞计数、各随访时间点的血糖水平以及移植后不良事件的发生率及其危险因素。在随访期间,采用统计方法比较并系统分析各组临床指标和不良事件的差异。在根据CDC-XM水平和HLA匹配划分的每个不同组中,随访期间各组临床指标的差异主要集中在移植后第一周,其中与肾功能相关的指标差异最大,而在1-6个月期间观察到的恢复情况基本相当。根据多因素分析,年龄≥40岁且BMI≥25的受者发生移植肾功能延迟恢复(DGF)的风险倾向于增加,而当器官由活体供者捐献且HLA错配数为0-2时,风险会降低。总之,本研究表明CDC阴性和改善的HLA匹配有助于促进肾移植受者术后早期肾功能的恢复。符合CDC阴性且HLA错配较少条件的患者术后肾功能恢复更快、更好,DGF的发生率更低。此外,在对DGF的多因素分析中,受者年龄、受者BMI、供者类型和HLA错配被发现是DGF的重要危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eb1/11955818/b12c502d8866/etm-29-05-12849-g00.jpg

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