实用器官移植电子杂志

实用器官移植电子杂志 ›› 2020, Vol. 8 ›› Issue (5): 375-379.DOI: 10.3969/j.issn.2095-5332.2020.05.010

• 论著 • 上一篇    下一篇

肾移植术后天然抗体对受者预后影响的相关性研究

刘伟 1 ，赵杰 2 ，宋广平 1 ，刘伟 1 ，赵一贺 1 ，李代红1
  

  1. 1. 天津市第一中心医院输血科， 天津 300192 ； 2. 天津市第一中心医院移植外科，天津 300192
  • 出版日期:2020-09-20 发布日期:2021-06-02
  • 基金资助:
    天津市第一中心医院临床试验项目（LC2018028）

A retrospective study on the effect of natural antibody on the prognosis of recipients after renal transplantation

Liu wei 1 ，Zhao jie 2 ，Song Guangping 1 ，Liu wei 1 ，Zhao Yihe 1 ，Li Daihong 1 .   

  1. 1.Departments of Blood Transfusion，Tianjin First Central Hospital，Tianjin 300192，China ； 2. Departments of Transplantation Surgery，Tianjin First Central Hospital， Tianjin 300192，China
  • Online:2020-09-20 Published:2021-06-02

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摘要：

目的 探讨肾移植术后天然抗体（natural antibodies，Nabs）对移植肾长期存活与排斥反应的 影响。方法 回顾性分析 44 例发生抗体介导排斥反应肾移植受者的病例资料 ，用酶联免疫吸附试验（enzyme linked immunosorbent assay，ELISA）检测 Nabs，根据 Nabs 的产生情况将受者分成 Nabs+ 组（10 例）和 Nabs- 组（34 例），分别记录受者移植术后移植物存活情况，并同时观察发生排斥反应时各组肾功能和移植 肾病理表现的差异 。结果 Nabs+ 组移植术后移植物存活率明显低于 Nabs- 组，差异有统计学意义（P ＝ 0.044）。移植后 Nabs 也与肾活检标本中移植物损伤的组织学征象的平均 Banff 评分增加相关。Nabs+ 组与 Nab- 组相比，肾小球滤过率估计值（estimated glomerular filtration rate，eGFR）有所下降，但差异无显著性 （P ＞ 0.05）。结论 Nabs 与移植肾损伤及肾功能衰竭相关，从而提示 Nabs 可能参与了排斥反应的免疫机制。

关键词: 肾移植 , 天然抗体 , 抗体介导排斥反应 , 移植物损伤

Abstract:

Objective To investigate the effect of natural antibodies（Nabs）on long-term survival and rejection after renal transplantation. Methods The clinical data of 44 renal transplant recipients with antibodymediated rejection were studied retrospectively. Nabs was detected by enzyme linked immunosorbent assay（ELISA） method. According to the production of Nabs，the recipients were divided into Nabs+ group（n = 10）and Nabs- group （n = 34）. The graft survival after transplantation was recorded，and the differences of renal function and pathology of each group during rejection were observed at the same time. Results The graft survival rate in Nabs+ group was significantly lower than that in Nabs- group（P ＝ 0.044）. Post-transplant Nabs was also associated with an increase in the average Banff score of histological signs of graft injury in renal biopsy specimens. Estimated glomerular filtration rate（eGFR）in Nabs+ group was lower than that in Nab- group，but there was no significant difference （P ＞ 0.05）. Conclusion Nabs is associated with renal allograft injury and renal failure，suggesting that Nabs may be involved in the mechanism of immune rejection.

Key words: Renal transplantation, Natural antibody, Antibody mediated rejection, Graft injury

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