活体肾供体与受体之间HLA - DR配型及移植前输血对移植物存活的影响。

Effect of HLA-DR matching between living kidney donors and recipients and of pretransplant blood transfusions on graft survival.

作者信息

Akiyama N, Sugimoto H, Kusaba R, Takahashi I, Ohsawa N, Inou T, Samaru Y

出版信息

Jpn J Exp Med. 1981 Feb;51(1):37-43.

Abstract

The effect of HLA-DR matching between living kidney donors and related recipients on 1-year graft survival was examined in 35 transplant recipients excluding 2-haplotype identical siblings. All 11 DR-compatible grafts survived 1 year; 7 of 24 DR-incompatible grafts ceased to function within 1 year (p less than 0.05). Among 24 DR-incompatible recipients, 6 of 11 who had preoperatively been transfused with less than 1000 ml blood lost their graft function. On the other hand, 12 of 13 who had received at least 1200 ml blood maintained their graft function beyond 1 year (p less than 0.05). All DR-compatible recipients received pretransplant blood transfusions and all produced anti-DR antibodies against random panel B cells after transplantation, but not against the graft donor's B lymphocytes. The anti-DR antibodies disappeared within 3 months. In recipients whose sera broadly reacted to random panel B cells at 1 years after transplantation, only 4 of 10 grafts survived. In recipients whose sera had lost their anti-DR reactivity within 1 year, all 20 grafts survived (p less than 0.05).

摘要

在35例移植受者（不包括2个单倍型相同的同胞）中，研究了活体肾供者与相关受者之间HLA - DR配型对1年移植肾存活的影响。所有11例DR配型相合的移植肾均存活1年；24例DR配型不相合的移植肾中有7例在1年内失去功能（p<0.05）。在24例DR配型不相合的受者中，术前输血少于1000ml的11例中有6例移植肾功能丧失。另一方面，接受至少1200ml血液的13例中有12例移植肾功能维持超过1年（p<0.05）。所有DR配型相合的受者移植前均接受输血，且移植后均产生针对随机B细胞板的抗DR抗体，但不针对移植供者的B淋巴细胞。抗DR抗体在3个月内消失。移植后1年血清对随机B细胞板有广泛反应的受者中，10例移植肾仅4例存活。血清在1年内失去抗DR反应性的受者中，20例移植肾全部存活（p<0.05）。