Cheigh J S, Fotino M, Stubenbord W T, Suthanthiran M, Riggio R R, Saal S D
JAMA. 1981 Jul 10;246(2):135-9.
The total number of cadaveric kidney transplants has been declining, despite an increasing dialysis population, greater understanding of transplant immunology, and improved transplant management. To explore the causes of this decline, various factors were studied in 140 dialysis patients who were awaiting transplantation and 100 consecutive recipients of cadaveric kidney transplants. The study indicates that there is a growing, now predominant, prospective kidney recipient population that is highly sensitized because of previous blood transfusions and kidney transplantations. As a result, 92% of the prospective recipients exhibit varying degrees of lymphocytotoxic antibodies. Thus, a major problem in clinical transplantation is the growing number of dialysis patients who are virtually untransplantable. The declining number of cadaveric kidney transplantations may be caused by, in part, changing immunologic characteristics in the recipient population.
尽管透析患者数量不断增加，对移植免疫学的认识更加深入，移植管理也有所改善，但尸体肾移植的总数却一直在下降。为了探究这种下降的原因，我们对140名等待移植的透析患者和100名连续接受尸体肾移植的受者的各种因素进行了研究。研究表明，由于先前的输血和肾移植，现在有越来越多、占主导地位的高敏前瞻性肾移植受者群体。因此，92%的前瞻性受者表现出不同程度的淋巴细胞毒性抗体。因此，临床移植中的一个主要问题是几乎无法进行移植的透析患者数量不断增加。尸体肾移植数量的下降可能部分是由于受者群体免疫特征的变化。
