中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2011年
10期
596-599
,共4页
高霞%唐敏英%王庆华%尚乐乐%蔡锦全%杨顺良%郭君其%吴卫真%谭建明
高霞%唐敏英%王慶華%尚樂樂%蔡錦全%楊順良%郭君其%吳衛真%譚建明
고하%당민영%왕경화%상악악%채금전%양순량%곽군기%오위진%담건명
肾移植%供者特异性抗体
腎移植%供者特異性抗體
신이식%공자특이성항체
Kidney transplantation%DSA
目的 总结应用单抗原微珠抗体检测肾移植受者体内供者特异性抗体(DSA)的经验,并探讨阳性DSA的处理方法及对移植肾功能的影响.方法 应用流式细胞微珠法检测亲属肾移植受者移植前后单抗原微珠抗体,并分析DSA与排斥反应、移植肾功能的关系.结果 30例患者,检测样本173份,其中移植前47份,移植后126份.移植前1例出现DSA,移植后8例出现DSA,应用硼替佐米及增加免疫抑制剂治疗.应用硼替佐米治疗者1例DSA免疫荧光强度下降至阴性水平,2例下降超过50％.出现DSA时与未出现DSA时的估算肾小球滤过滤分别为(1.50±0.59) ml/s与(1.23±0.38) ml/s,差异有统计学意义(P＜0.05).结论 采用单抗原微珠抗体动态检测DSA的效果好,DSA的出现影响了移植肾eGFR,应用硼替佐米治疗可使DSA免疫荧光滴度下降.
目的 總結應用單抗原微珠抗體檢測腎移植受者體內供者特異性抗體(DSA)的經驗,併探討暘性DSA的處理方法及對移植腎功能的影響.方法 應用流式細胞微珠法檢測親屬腎移植受者移植前後單抗原微珠抗體,併分析DSA與排斥反應、移植腎功能的關繫.結果 30例患者,檢測樣本173份,其中移植前47份,移植後126份.移植前1例齣現DSA,移植後8例齣現DSA,應用硼替佐米及增加免疫抑製劑治療.應用硼替佐米治療者1例DSA免疫熒光彊度下降至陰性水平,2例下降超過50％.齣現DSA時與未齣現DSA時的估算腎小毬濾過濾分彆為(1.50±0.59) ml/s與(1.23±0.38) ml/s,差異有統計學意義(P＜0.05).結論 採用單抗原微珠抗體動態檢測DSA的效果好,DSA的齣現影響瞭移植腎eGFR,應用硼替佐米治療可使DSA免疫熒光滴度下降.
목적 총결응용단항원미주항체검측신이식수자체내공자특이성항체(DSA)적경험,병탐토양성DSA적처리방법급대이식신공능적영향.방법 응용류식세포미주법검측친속신이식수자이식전후단항원미주항체,병분석DSA여배척반응、이식신공능적관계.결과 30례환자,검측양본173빈,기중이식전47빈,이식후126빈.이식전1례출현DSA,이식후8례출현DSA,응용붕체좌미급증가면역억제제치료.응용붕체좌미치료자1례DSA면역형광강도하강지음성수평,2례하강초과50％.출현DSA시여미출현DSA시적고산신소구려과려분별위(1.50±0.59) ml/s여(1.23±0.38) ml/s,차이유통계학의의(P＜0.05).결론 채용단항원미주항체동태검측DSA적효과호,DSA적출현영향료이식신eGFR,응용붕체좌미치료가사DSA면역형광적도하강.
Objective To analyze the clinical application of donor specific antibodies (DSAs) detected by a single antigen Luminex virtual crossmatch,and to discuss the treatment of DSA and the impact of DSA on renal function.Methods Serum from living-relative renal recipients before and after transplantation was investigated using a Luminex single antigen assay.The relation between DSA and renal acute rejection as well as renal function was analyzed.Results A total of 30 patients and 173 serum samples were tested,including 47 serum samples before transplantation,and 126 after transplantation.DSA was positive in one patient before transplantation,and 8 patients after transplantation.Three of the patients positive for DSA were treated by Bortezomib,3 by addition of MMF,2 by addition of CNI,1 by addition of Sirolimus.The MFI of DSA in one of the patients treated by Bortezomib was decreased to below 1000,while that in the other two decreased by more than 50 ％.The renal eGFR at the time with and without DSA was (1.50 ± 0.59) and (1.23 ± 0.38)ml/s respectively (P＜0.05).Conclusion Dynamic monitoring of single bead antigen antibody DSA conduces to direct the adjustment of immunosuppressant.The appearance of DSA contributes to the declination of renal function.Application of Bortezomib decreased the MFI of DSA.
