Etheredge E E, Bettonville P, Sicard G A, Anderson C B
Tissue Antigens. 1982 Mar;19(3):205-12. doi: 10.1111/j.1399-0039.1982.tb01441.x.
ABO blood group compatibility is generally required for successful human kidney transplants and new data suggest donor-recipient incompatibility for the Lewis or multiple minor blood groups is detrimental. This is of special importance in the setting of liberal transfusions prior to transplant. To assess the impact of immunizing exposure to disparate blood groups of ABO-matched transfusions and kidney transplants, we studied the interrelationships of anti-erythrocyte antibodies, leukocytotoxins and graft survival in 42 kidney transplant recipients. Three hundred forty-four sera were screened for anti-erythrocyte antibodies using standard hemagglutination techniques and leukocytotoxins, using the antiglobulin method. Statistical analysis by computer used a 2 x 2 x 2 contingency table with model fitting. Only 13 of 42 patients had anti-erythrocyte antibodies at some time: anti-I (4); anti-Kell (1); cold panagglutinin (7); unidentifiable agglutinin (1). Of 42 patients, 16 had no detectable leukocytotoxins. By computer analysis, immunizations to blood group and HLA antigens were independent phenomena. Analysis showed that leukocytotoxins, but not anti-erythrocyte antibodies, were associated with poor graft survival. A computer generated probability of graft survival by antibody status is presented. We conclude that immunization to blood group antigens is not common, is largely non-specific, and is not detrimental to kidney graft survival.
成功进行人类肾脏移植通常需要ABO血型相容，并且新数据表明供体与受体的Lewis血型或多种次要血型不相容是有害的。这在移植前大量输血的情况下尤为重要。为了评估ABO血型匹配输血和肾脏移植中不同血型的免疫暴露影响，我们研究了42名肾脏移植受者的抗红细胞抗体、白细胞毒素与移植物存活之间的相互关系。使用标准血凝技术筛查344份血清中的抗红细胞抗体，并使用抗球蛋白方法检测白细胞毒素。通过计算机进行的统计分析采用了带有模型拟合的2×2×2列联表。42名患者中只有13名在某些时候有抗红细胞抗体：抗-I（4名）；抗-Kell（1名）；冷凝集素（7名）；无法识别的凝集素（1名）。42名患者中，16名未检测到白细胞毒素。通过计算机分析，血型免疫和HLA抗原免疫是独立现象。分析表明，白细胞毒素而非抗红细胞抗体与移植物存活率低有关。给出了根据抗体状态通过计算机生成的移植物存活概率。我们得出结论，血型抗原免疫并不常见，大多是非特异性的，并且对肾脏移植物存活无害。
