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目的 研究移植前预致敏状态对移植肾生存率的影响。方法 分析我院 175例次再次肾移植的 1、2、3年移植肾存活率 ,及肾移植受者术前血清群体反应抗体 (PRA )水平对移植肾存活率的影响。结果 再次移植 1、2、3年的移植肾存活率分别为 6 0 .2 %、48.5 %和 34 .4% ,明显低于首次移植的 82 .7%、71.8%和 5 0 .6 %。在近 3年32 0例淋巴毒交叉配型结果 (CDC)≤ 5 %的患者中 ,有 40例患者血清的 PRA≥ 5 0 % ,其中 14例为首次移植 ,移植肾的一年存活率为 79.5 % ,2 6例为再次移植 ,存活率为 6 1.5 % (P<0 .0 5 )。而 2 80例血清 PRA <5 0 %的患者移植肾一年存活率 ,首次移植者为 89.3% ,再次移植者为 79.2 % (P<0 .0 5 )。结论 本研究结果表明 ,移植前患者的 PRA水平以及再次移植是影响移植肾存活率的重要因素。
Objective To study the effect of pre-sensitization on graft survival rate after transplantation. Methods The survival rates of 1, 2 and 3 years after renal transplantation were retrospectively analyzed in 175 cases of our hospital and the effect of preoperative serum antibody (PRA) level on the survival rate of renal allograft recipients. Results The 1, 2 and 3 years after transplantation, the graft survival rates were 60.2%, 48.5% and 34.4%, respectively, which were significantly lower than those of the first transplantation 82.7%, 71.8% and 50.6%. Of the 32 patients with lymph node CDC ≤ 5% in the past 3 years, 40 had serum PRA ≥ 50%, of whom 14 had a first transplant and one year of graft survival was 79.5%, 26 cases were replanted, the survival rate was 6 1.5% (P <0.05). The one-year survival rate of renal transplant recipients with PRA <50% in 2 80 cases was 89.3% for the first transplant and 79.2% for the second transplant (P <0.05). Conclusions The results of this study suggest that PRA levels before transplantation and retransplantation are important factors that influence graft survival.