CAJ | 학술논문

背景:微嵌合作为移植物与受者之间的双相细胞移动的标志,在移植免疫耐受中的作用日益受到重视.目的:探讨夫妻生活与嵌合体的发生,与肾移植后急性排斥反应及其他相关性的研究.方法:将接受肾脏移植的女性受者(有过生育史的女性除外)分为丈夫活体供肾组、无关男性尸体供肾组,并设立接受妻子活体供肾的对照组.STR 方法检测女性受者体内男性供者来源的 Y 染色体反映微嵌合体的存在,与急性排斥反应发生的关系,并比较配偶间供肾效果的差异.结果与结论:尽管配偶间供肾移植存在供者年龄偏大以及人类白细胞抗原错配率较高的因素,但与接受无关男性尸肾移植的女性受者相比,接受丈夫活体供肾移植的女性更易检测出微嵌合体,而且肾移植后恢复情况好,急性排斥反应发生率低.而与接受妻子供肾的丈夫相比,接受丈夫供肾的妻子肾移植效果好.说明夫妻间长期相处导致女性接受丈夫体液的机会多,由此产生免疫耐受对于肾移植后人/肾的相容性好,急性排斥反应小.
배경:미감합작위이식물여수자지간적쌍상세포이동적표지,재이식면역내수중적작용일익수도중시.목적:탐토부처생활여감합체적발생,여신이식후급성배척반응급기타상관성적연구.방법:장접수신장이식적녀성수자(유과생육사적녀성제외)분위장부활체공신조、무관남성시체공신조,병설립접수처자활체공신적대조조.STR 방법검측녀성수자체내남성공자래원적 Y 염색체반영미감합체적존재,여급성배척반응발생적관계,병비교배우간공신효과적차이.결과여결론:진관배우간공신이식존재공자년령편대이급인류백세포항원착배솔교고적인소,단여접수무관남성시신이식적녀성수자상비,접수장부활체공신이식적녀성경역검측출미감합체,이차신이식후회복정황호,급성배척반응발생솔저.이여접수처자공신적장부상비,접수장부공신적처자신이식효과호.설명부처간장기상처도치녀성접수장부체액적궤회다,유차산생면역내수대우신이식후인/신적상용성호,급성배척반응소.
BACKGROUND: Microchimerism as the sign of biphasic cel migration between the graft and the recipient has attracted more and more attention in transplantation tolerance. OBJECTIVE: To investigate the relationship between spousal life and occurrence of chimerism and the acute rejection after renal transplantation. METHODS: The female kidney transplant recipients (except the females have reproductive history) were divided into two groups: husband living kidney donation group and unrelated male cadaver kidney donation group. Control group was set for husband recipients who received the living kidney donation of their wives. The Y chromosome from the male donor in the female recipients was detected by STR to reflect the presence of microchimerism as wel as the correlation with acute rejection. The effect of the donor kidney was compared between spouses. RESULTS AND CONCLUSION: Though there was a higher rate of human leukocyte antigen mismatches and elder donor age between spouses, the female recipients received husband living kidney donation detected the microchimerism more easily when compared with the female recipients received unrelated male cadaver kidney donation, and female recipients received husband living kidney donation could recover quickly with lower acute rejection rate. Compared with the husband received wife living kidney donation, the wife received husband living kidney donation had better effect after renal transplantation. It indicates that long terms of spousal life leads to more opportunity of accepting her husband’s humoral, so result in the immune tolerance with good kidney compatibility after renal transplantation and low acute rejection rates.