Heidenreich S, Tepel M, Fahrenkamp A, Rahn K H
Department of Medicine, University of Münster, Germany.
Am J Kidney Dis. 1995 May;25(5):775-80. doi: 10.1016/0272-6386(95)90554-5.
Since renal allograft rejection is frequently associated with a blunted erythropoiesis, we investigated erythropoietin (EPO) serum concentrations in 17 patients with acute rejection, eight patients with chronic rejection, and 18 transplant recipients with stable graft function. All rejection episodes were proven by biopsy. Erythropoietin serum levels were significantly reduced in patients with chronic rejection (6.2 +/- 3.4 mU/mL; P < 0.01) compared with individuals with acute rejection (35.6 +/- 33.9 mU/mL) or stable graft function (24.0 +/- 19.7 mU/mL). Suppressed EPO levels were associated with marked anemia in chronic rejection patients. In a subgroup of patients with acute rejection and bad responses to an intensified immunosuppressive regimen or with transplant failure, we found significantly suppressed EPO levels (11.6 +/- 6.1 mU/mL) compared with a subgroup of patients with a beneficial acute rejection outcome (57.0 +/- 34.2 mU/mL; P < 0.01). A correlation between histologic parameters of acute rejection and hormone levels showed that signs of moderate glomerulitis were associated with elevated EPO levels, whereas lesions of moderate tubulitis were associated with low values. We conclude that serum EPO may have prognostic value for rejection outcome in renal transplant recipients.
由于肾移植排斥反应常伴有红细胞生成受抑制，我们对17例急性排斥反应患者、8例慢性排斥反应患者以及18例移植肾功能稳定的受者的促红细胞生成素（EPO）血清浓度进行了研究。所有排斥反应均经活检证实。与急性排斥反应患者（35.6±33.9 mU/mL）或移植肾功能稳定者（24.0±19.7 mU/mL）相比，慢性排斥反应患者的促红细胞生成素血清水平显著降低（6.2±3.4 mU/mL；P<0.01）。促红细胞生成素水平受抑制与慢性排斥反应患者的明显贫血有关。在急性排斥反应患者亚组中，对强化免疫抑制方案反应不佳或移植失败的患者，与急性排斥反应预后良好的患者亚组相比，促红细胞生成素水平显著受抑制（11.6±6.1 mU/mL）（57.0±34.2 mU/mL；P<0.01）。急性排斥反应的组织学参数与激素水平之间的相关性表明，中度肾小球炎的迹象与促红细胞生成素水平升高有关，而中度肾小管炎的病变与低值有关。我们得出结论，血清促红细胞生成素可能对肾移植受者的排斥反应预后具有预后价值。
