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首页> 外文期刊>Transplantation: Official Journal of the Transplantation Society >Screening for de novo anti-human leukocyte antigen antibodies in nonsensitized kidney transplant recipients does not predict acute rejection.
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Screening for de novo anti-human leukocyte antigen antibodies in nonsensitized kidney transplant recipients does not predict acute rejection.

机译：在未致敏的肾移植接受者中从头筛选抗人类白细胞抗原抗体不能预测急性排斥反应。

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摘要

BACKGROUND: The purpose of this study was to determine whether screening for anti-human leukocyte antigen (HLA) antibodies (Abs) could predict development of acute rejection (AR) before clinical evidence of kidney allograft dysfunction in nonsensitized recipients. METHODS: Eighty-four non-HLA identical kidney transplant recipients were prospectively tested for anti-HLA Abs (FlowPRA analysis and anti-HLA Ab specificity determination) at 0, 10, 20, 30, 60, 90, 180 and 365 posttransplantation, and at the time of clinical suspicion of AR. Allograft biopsies were performed at the time of engraftment, 3 and 12 months posttransplantation, when patients developed new anti-HLA Abs, or when clinically indicated. RESULTS: Among the 70 patients without preformed anti-HLA Abs, 11 developed de novo anti-HLA Abs (8 donor-specific Abs) at a median of 30 days (q1-q3=10-180 days) after transplantation. Patients with de novo anti-HLA Abs had a shorter time to AR than patients without de novo anti-HLA Abs, P=0.06. However, in all cases, de novo anti-HLA Abs developed concomitantly or after a clinically evident AR. CONCLUSIONS: Although de novo anti-HLA Abs were associated with AR, routine screening for anti-HLA Abs was not useful in identifying patients at risk for AR before clinical evidence of allograft dysfunction.
机译：背景：本研究的目的是确定在未致敏的受体中发生同种异体肾功能不全的临床证据之前，筛查抗人类白细胞抗原（HLA）抗体（Abs）是否可以预测急性排斥（AR）的发生。方法：在移植后0、10、20、30、60、90、180和365分别对84名非HLA相同的肾脏移植受者进行了抗HLA Abs（FlowPRA分析和抗HLA Ab特异性测定）测试，并在临床上怀疑AR时。同种异体移植活检在移植时，移植后3个月和12个月，患者出现新的抗HLA抗体或临床适应症时进行。结果：在70例未形成抗HLA抗体的患者中，有11例在移植后30天（q1-q3 = 10-180天）的中位出现了新生的抗HLA Abs（8个供体特异性Abs）。从头抗HLA Abs的患者比没有从头抗HLA Abs的患者的AR时间短，P = 0.06。然而，在所有情况下，从头抗HLA Abs伴随或在临床上明显的AR后发展。结论：尽管从头抗-HLA Abs与AR相关，但是常规抗-HLA Abs筛查在同种异体移植功能障碍的临床证据出现之前不能用于确定有AR风险的患者。

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