胰肾联合移植术后移植前及新生抗hla抗体检测的意义

I. Dmitriev, N. Borovkova, S. Shchelykalina, N. V. Doronina, N. Zhuravel, A. Pinchuk
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引用次数: 0

摘要

介绍。目前,对胰肾联合移植术后患者移植前及新生抗hla抗体水平测定的临床意义评价研究较少。胰肾联合移植术后患者移植前和新生hla抗体的发生率、形成时间和特异性的研究。材料和方法。我们进行了一项前瞻性和回顾性研究,研究了2008年至2022年在N.V. Sklifosovsky急救医学研究所进行的55例胰肾联合移植术后移植前和新生抗hla抗体的发生率、形成时间和特异性。hla抗体预形成4例(7%)。17例患者(31%)在胰肾联合移植术后出现hla抗体。抗hlaⅰ类患者5例,抗hlaⅱ类患者3例,抗hlaⅰ类和抗hlaⅱ类患者3例,抗mica患者5例,同时抗hla和抗mica患者1例。新生hla抗体的形成显著增加急性排斥反应的发生率(47%比13%,p=0.014)。本中心受者移植前和新生抗hla抗体检测频率与其他移植中心公布的数据相当。我们获得的证据表明,新抗hla抗体的形成增加了胰肾联合移植后急性排斥反应的发生率。
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Significance of pretransplant and de novo anti-HLA antibody detection after simultaneous pancreas-kidney transplantation
Introduction. Nowadays, there are few studies concerning assessment of the clinical significance of determining the level of pretransplant and de novo anti-HLA antibodies in patients after simultaneous pancreas-kidney transplantation.Aim. The study of the incidence, timing of formation and specificity of pretransplant and de novo anti-HLA antibodies in patients after simultaneous pancreas-kidney transplantation.Material and methods. We conducted a prospective and retrospective research to study the incidence, timing of formation and specificity of pretransplant and de novo anti-HLA antibodies in 55 patients after simultaneous pancreas-kidney transplantation performed at the N.V. Sklifosovsky Research Institute for Emergency Medicine from 2008 to 2022.Results. There were 4 patients with preformed anti-HLA antibodies (7%). The formation of de novo anti-HLA antibodies after simultaneous pancreas-kidney transplantation was observed in 17 patients (31%). There were 5 patients with antiHLA class I, 3 patients with anti-HLA class II, 3 patients with anti-HLA class I and II, 5 patients with anti-MICA and 1 patient with both classes of anti-HLA and anti-MICA. The formation of de novo anti-HLA antibodies significantly increased the incidence of acute rejection (47% compared with 13%, p=0.014).Conclusion. The frequency of pretransplant and de novo anti-HLA antibody detection in the recipients at our Center is comparable to published data from other transplant centers. We obtained evidence that the formation of de novo antiHLA antibodies increases the incidence of acute rejection after simultaneous pancreas-kidney transplantation.
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