阳性交叉配型情况下的肾移植：单中心经验

Renal transplantation performed across a positive crossmatch: a single centre experience.

作者信息

Leavey S F, Walshe J J, O'Neill D, Atkins N, Donohoe J, Hickey D, Carmody M

机构信息

Department of Nephrology, Beaumont Hospital, Dublin, Ireland.

出版信息

Ir J Med Sci. 1997 Oct-Dec;166(4):245-8. doi: 10.1007/BF02944244.

DOI:10.1007/BF02944244

PMID:9394076

Abstract

UNLABELLED

The importance of certain positive crossmatches (CM+) in kidney transplantation remains controversial. Fifty consecutive kidney transplants were performed across a CM+ between Jan. 1990-April 1994. In 19 cases there was an isolated B-cell CM+ (Group I), in 24 an historic T-cell IgM CM+ (Group II) and in 7 an historic T-cell IgG CM+ (Group III). Comparing groups I:II:III: early acute rejection affected 32%, 42%, 57% of grafts; mean serum creatinine at 3 months was 166, 150, 229 umol/l (p < 0.05); 1 yr graft survival was 95 per cent, 96 per cent, 71 per cent (p = 0.09). In group III both graft losses were in the setting of an additional current B-cell CM+.

CONCLUSIONS

Transplantation performed in either the presence of an isolated B-cell CM+ or in the presence of an historic T-cell IgM CM+ was associated with acceptable outcomes at 1 yr. An historic T-cell IgG CM+ was confirmed as a contraindication to transplantation in most circumstances, especially when coupled with a current B-cell CM+.

摘要

未标记

肾移植中某些阳性交叉配型（CM+）的重要性仍存在争议。1990年1月至1994年4月期间，连续进行了50例跨越CM+的肾移植。其中19例为单纯B细胞CM+（第一组），24例为既往T细胞IgM CM+（第二组），7例为既往T细胞IgG CM+（第三组）。比较第一组、第二组和第三组：早期急性排斥反应分别影响32%、42%、57%的移植物；3个月时的平均血清肌酐分别为166、150、229 μmol/L（p<0.05）；1年移植物存活率分别为95%、96%、71%（p=0.09）。在第三组中，两次移植物丢失均发生在同时存在当前B细胞CM+的情况下。