Abstract:

Objective To observe the efficacy and safety of T lymphocyte polyclonal antibody in deceased donor （DD）kidney transplantation. Methods The clinical data of 324 renal transplant recipients who met the research criteria from August 20，2015 to February 28，2020 in our hospital were retrospectively analyzed. They were divided into two groups. A total number of 147 patients were treated with rabbit anti humanthymocyte immunoglobulin（rATG）（group A）. 177 patients were treated with anti human T lymphocyte rabbit immunoglobulin （ATG-Fresenius）（group B）. The acute rejection （AR）， delayed graft function （DGF），lung infection， bone marrow suppression and cytomegalovirus （CMV） infection were compared between the two groups. Results The incidence of AR in group A and group B was 32.65% and 16.94% respectively （P ＜ 0.05）. There were 17 cases of AR in group A（17/48）and 23 cases in group B（23/30）within one month after operation（χ2 ＝ 12.573 7，P ＜ 0.01）. The incidence of AR in group A was lower than that in group B （P ＜ 0.01）. Theincidence of DGF was 25.17% （37/147）in group A and 12.42% （22/177）in group B （P ＜ 0.01）. Thirty days after operation，the incidence of DGF in group A was lower than that in group B（P ＜ 0.01）.There was no significant difference in the adverse events of bone marrow suppression，pulmonary infection andCMV infection（P ＞ 0.05）. Conclusion In our hospital，both rATG and ATG-F can be safely and effectively used in the induction and postoperative treatment of DD renal transplantation. The rATG has a better performance in correcting the DGF and reducing the incidence of AR in DD kidney transplantation.

Key words:

Deceased donation , Kidney transplantation , T lymphocyte polyclonal antibody , Delayed graft function, Acute rejection

摘要：

目的 观察 T 细胞多克隆抗体在公民逝世后器官捐献（deceased donation，DD）供肾移植患者中的有效性和安全性。方法 回顾性分析昆明市第一人民医院甘美医院自 2015年 8 月 20 日至 2020 年2 月 28 日符合研究标准的共 324 例肾移植受者资料，将其分为使用兔抗人胸腺细胞免疫球蛋白（rabbit anti human thymocyte immunoglobulin，rATG）的患者（A 组）147 例，使用抗人 T 细胞兔免疫球蛋白（anti-human T lymphocyte rabbit immunoglobulin，ATG-Fresenius）（B 组）的患者 177 例，比较两组患者急性排斥反应（acuterejection，AR）发生情况、术后移植肾功能延迟恢复（delayed graft function，DGF）的情况以及肺部感染、骨髓抑制、巨细胞病毒（cytomegalovirus，CMV）感染情况等。结果 A 组和 B 组在 DD 供肾移植中术后 1 年内 AR 发生率分别为 32.65%、16.94%（P ＜ 0.05）；术后 1 个月内 A 组发生 AR 为 17 例（17/48），B 组发生AR 为 23 例（23/30），两组相比具有统计学意义（χ2 ＝ 12.5737，P ＜ 0.01），A 组 AR 发生率低于 B 组 ；A 组和 B 组的 DGF 发生率分别为 25.17%（37/147）和 12.42%（22/177）（P ＜ 0.01）；术后 30 d，A 组 DGF发生率较 B 组更低（P ＜ 0.01）；术后骨髓抑制、肺部感染、CMV 感染 3 个方面不良事件比较，差异无统计学意义（P ＞ 0.05）。结论 rATG 和 ATG-F 均能安全有效地运用于 DD 肾移植术前诱导及术后治疗，rATG纠正 DD 供肾移植中 DGF 的作用及降低 AR 的发生率有着更优的表现。

关键词:

公民逝世后器官捐献 , 肾移植 , T 细胞多克隆抗体 , 移植肾功能延迟恢复 , 急性排斥反应