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目的 :探讨早期移植肾丢失引起HLA体液致敏的机制。方法 :采用LAT ELISA法分别检测 3例首次尸肾移植丢失的受者术前 1周、术后 1个月群体反应性抗体 (PRA)IgG类HLA抗体水平 ,并分析其性质。 结果 :1例女性受者术前 1周PRA水平Ⅰ类为 17.9% ,其抗体特异性为B6 0 ,Ⅱ类为阴性 ;术后 1个月PRA水平Ⅰ类为 39.3% ,其抗体特异性为B17,Ⅱ类为阴性。 2例男性受者术前 1周Ⅰ、Ⅱ类PRA为阴性 (PRA <10 % )。术后 1个月Ⅰ类PRA水平分别为 4 6 .4 %和 4 1.7% ,其抗体特异性分别为B6 3、B2 2 ;Ⅱ类PRA水平分别为 2 5 .0 %、2 3.1% ,其抗体特异性均为DR5 3。结论 :移植肾丢失患者术后产生抗供者特异性抗体 (Ds Ab) ,表明移植物是机体HLA体液致敏的重要危险因素之一。
Objective: To investigate the mechanism of HLA sensitization caused by early renal allograft loss. Methods: LAT ELISA was used to detect the levels of IgG antibodies against PRA in the recipients who were lost to the first cadaveric renal transplantation in one week and one month after the operation, respectively. Results: In the 1 week before operation, the level of PRA was 17.9% in class I, the antibody specificity was B6 0, and the class Ⅱ was negative. The level of PRA in class I was 39.3% at 1 month after operation. The antibody specificity was B17, class Ⅱ is negative. Two cases of male recipients had negative PRA Ⅰ and Ⅱ (PRA <10%) 1 week before operation. The level of type 1 PRA at 1 month after operation was 46.4% and 41.7% respectively, and the antibody specificity was B6 3 and B2 2 respectively. The level of PRA in group Ⅱ was 25.0% and 23.1% respectively Antibody specificity is DR5 3. CONCLUSIONS: Anti-donor-specific antibodies (Ds Abs) were produced postoperatively in patients with renal transplant loss, indicating that the graft is one of the important risk factors for the sensitization of the body to HLA.