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目的:分析肾移植供受者间人类白细胞抗原(human leucocyte antigen,HLA)错配率。方法:来自36家移植中心的6 025例肾移植供、受者分为两组:3 916例等候肾移植受者和1 914例尸体供者为未知组;已接受肾移植术的127例受者和68例尸体供者为已知组。未知组为肾移植最大可能的供受者对,而已知组为实际的肾移植供受者对。统计并比较两组供受者间HLA-A、B、DR各位点0～2个错配(mismatch,MM)概率。结果:未知组供受者间HLA-A位点0～2 MM的概率分别为10.24%、51.79%和39.33%;B位点0～2个MM的概率分别为2.19%、33.68%和64.13%;DR位点0～2 MM的概率分别为3.69%、40.97%和55.34%。已知组供受者间HLA-A位点0～2 MM的概率分别为9.45%、58.27%和32.28%;B位点0～2 MM的概率分别为6.30%、30.71%和62.99%;DR位点0～2 MM的概率分别为7.87%、45.67%和46.46%。两组间比较仅B和DR位点0个MM差异有显著统计学意义,各位点1和2个MM的概率比较无显著差异。未知组和已知组供受者A、B、DR位点,2个MM的概率与0 MM的概率相比差异具有显著性。结论:肾移植供受者间HLA错配概率高,为降低HLA错配率,有必要建立国家级或地区性器官共享和分配中心。
Objective: To analyze the mismatch rate of human leucocyte antigen (HLA) between donor and recipient in renal transplantation. METHODS: Six 025 renal transplant recipients from 36 transplant centers were divided into two groups: 3 916 recipients of kidney transplant recipients and 1 914 cadaver donors were unknown; 127 received kidney transplantation And 68 cases of cadaver donor known group. The unknown group is the largest possible recipient of kidney transplants and the known group is the actual recipient of kidney transplants. The probability of mismatch (MM) of HLA-A, B and DR loci was calculated and compared between the two groups. Results: The odds of 0 ~ 2 MM in HLA-A loci of unknown donors were 10.24%, 51.79% and 39.33%, respectively. The probabilities of 0 ~ 2 MM in locus B were 2.19%, 33.68% and 64.13% ; The probability of DR site 0 ~ 2 MM were 3.69%, 40.97% and 55.34% respectively. The odds of 0 ~ 2 MM of HLA-A loci were 9.45%, 58.27% and 32.28% respectively in group donors and 6.30%, 30.71% and 62.99% in B locus. The probability of site 0 ~ 2 MM were 7.87%, 45.67% and 46.46% respectively. There was significant difference between the two groups in 0 MM only in B and DR sites, and there was no significant difference in the probability of 1 and 2 MM in each site. Unknown group and known group of donor A, B, DR sites, 2 MM probability and 0 MM probability difference was significant. Conclusion: The probability of HLA mismatch between donor and recipient in renal transplantation is high. To reduce the HLA mismatch rate, it is necessary to establish a national or regional organ sharing and distribution center.