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目的 检测肾移植长期存活受者的致敏状态 ,并分析其与移植肾功能的关系。方法 在定期随访的肾移植受者中 ,选取存活 3年以上的受者 6 6例 ,其中肾功能正常者 46例 ,慢性肾功能减退者 2 0例 ,用LambdaAntigenTray(LAT)酶联免疫试剂盒检测血清中的可溶性抗HLA抗体 ,分析抗体的类型和特异性、致敏与肾功能及移植后时间的关系。结果 肾功能正常组轻度、中度、高度致敏分别为 9例、0例、2例 ,肾功能减退组为 3例、1例、4例 ;移植后 3～ 5年、6～ 8年及 8年以上的致敏率没有差异 ;致敏类型 :肾功能正常组Ⅰ类抗原致敏 0例、Ⅱ类抗原致敏 8例、Ⅰ、Ⅱ类抗原同时致敏 3例 ,肾功能减退组分别为 1例、2例、5例。结论 致敏率与移植后的时间长短无关 ;HLAⅡ类抗原是致敏的主要原因 ;移植肾功能受损与高度致敏和Ⅰ、Ⅱ类抗原同时致敏有关
Objective To detect the sensitization status of long-term renal transplant recipients and to analyze their relationship with graft function. Methods Sixty-six recipients who survived for more than 3 years were enrolled in this study. 46 patients with normal renal function and 20 patients with chronic renal failure were enrolled in this study. Detection of serum soluble anti-HLA antibodies to analyze the type and specificity of antibodies, sensitization and renal function and the time after transplantation. Results The mild, moderate and highly sensitized patients with normal renal function were 9 cases, 0 cases, 2 cases, 3 cases of renal dysfunction group, 1 case, 4 cases; 3 to 5 years after transplantation, 6 to 8 years And no more than 8 years of sensitization rate. Sensitization type: 0 cases of type Ⅰ antigen sensitization in normal renal function group, 8 cases of type Ⅱ antigen sensitization, 3 cases of simultaneous sensitization of type Ⅰ and Ⅱ antigens, renal dysfunction group Respectively, 1 case, 2 cases, 5 cases. Conclusion The sensitization rate has nothing to do with the length of time after transplantation. The HLA Ⅱ antigen is the main reason of sensitization. The impaired graft function is associated with highly sensitized and class Ⅰ and Ⅱ antigen simultaneous sensitization