CAJ | 학술논문

目的：探讨供受者主要组织相容性复合物I类相关链A（MICA）抗体对肾移植术后早期移植肾功能的影响。方法采用Luminex200液相芯片技术，对43对肾移植供受者进行MICA抗体检测，其中26例尸体供者，所对应的43例受者。分为四组：（1）供受者均为MICA抗体阳性组；（2）供者MICA抗体阳性、受者MICA抗体阴性组；（3）供者MICA抗体阴性、受者MICA抗体阳性组；（4）供受者均为MICA抗体阴性组。比较各组之间术后急性排斥反应（AR）发生率、1周时血肌酐水平、移植肾功能恢复时间等资料，分析供受者MICA抗体对早期移植肾功能的影响。结果26例尸体供者中MICA抗体阳性者5例（19.2%），抗体特异性频率最高的是MICA*019（40%）；43例受者中MICA抗体阳性者11例（25.6%），抗体特异性频率最高的是MICA*018（14.6%）。43例受者肾移植后AR分析显示，第1组未发生AR（0/1）；第2组AR发生率为33.3%（2/6），第3组AR发生率为40%（4/10）；第4组AR发生率为38.4%（10/26）。各组之间AR发生率无统计学意义（P>0.05）；各组在术后1周时血肌酐水平以及移植肾功能恢复时间方面无统计学意义（均P>0.05）。结论供受者任何一方在肾移植前存在MICA抗体对术后早期受者的AR发生率和肾功能恢复无明显影响。
목적：탐토공수자주요조직상용성복합물I류상관련A（MICA）항체대신이식술후조기이식신공능적영향。방법채용Luminex200액상심편기술，대43대신이식공수자진행MICA항체검측，기중26례시체공자，소대응적43례수자。분위사조：（1）공수자균위MICA항체양성조；（2）공자MICA항체양성、수자MICA항체음성조；（3）공자MICA항체음성、수자MICA항체양성조；（4）공수자균위MICA항체음성조。비교각조지간술후급성배척반응（AR）발생솔、1주시혈기항수평、이식신공능회복시간등자료，분석공수자MICA항체대조기이식신공능적영향。결과26례시체공자중MICA항체양성자5례（19.2%），항체특이성빈솔최고적시MICA*019（40%）；43례수자중MICA항체양성자11례（25.6%），항체특이성빈솔최고적시MICA*018（14.6%）。43례수자신이식후AR분석현시，제1조미발생AR（0/1）；제2조AR발생솔위33.3%（2/6），제3조AR발생솔위40%（4/10）；제4조AR발생솔위38.4%（10/26）。각조지간AR발생솔무통계학의의（P>0.05）；각조재술후1주시혈기항수평이급이식신공능회복시간방면무통계학의의（균P>0.05）。결론공수자임하일방재신이식전존재MICA항체대술후조기수자적AR발생솔화신공능회복무명현영향。
Objective To investigate the effects of donor and recipient anti-major histocompatibility complex class I-related chain A (MICA) antibodies on early renal graft function in renal transplant recipients. Methods Using Luminex200 liquid chip technology, we detected anti-MICA antibodies in 26 deceased donors paired with 43 recipients. We divided the 43 pairs into 4 groups according to different donor and recipient anti-MICA antibody positivity statuses and compared the incidence of acute rejection (AR), serum creatinine at 1 week after transplantation, and renal function recovery time between the groups to assess the effect of donor and recipient anti-MICA antibodies on early graft function. Results Five of the 26 donors were positive for anti-MICA antibodies (19.2%), with the most common antibody being anti-MICA*019 (40%); 11 of the 43 recipients were positive for anti-MICA antibodies (25.6%), among which anti-MICA*018 was most frequently found (14.6%). AR did not occur in the only anti-MICA antibody-positive recipient receiving an anti-MICA antibody-positive donor graft;AR occurred in 2 (33.3%) of the 6 anti-MICA antibody-negative recipients receiving anti-MICA antibody-positive donor graft, in 4 (40%) out of the 10 anti-MICA antibody-positive recipients receiving anti-MICA antibody-negative donor graft, and in 10 (38.4%) of the 26 anti-MICA antibody-negative recipients receiving anti-MICA antibodies-negative donor graft. The incidences of AR were not significantly different between the groups (P>0.05), nor were serum creatinie levels or renal function recovery time at one week after surgery(P>0.05). Conclusion Donor or recipient anti-MICA antibody positivity does not seem to significantly affect the incidence of AR or renal function recovery early after transplantation to justify the necessity of monitoring donor anti-MICA antibodies. But still, large-sample studies are needed to further investigate the potential impact of donor and recipient anti-MICA antibodies on the outcomes of renal transplantation.