摘要
目的研究父母供肾对亲属活体肾移植受者移植肾长期存活的影响。方法回顾性分析首都医科大学附属北京友谊医院行父母供肾的亲属活体肾移植并存活5年以上的119例受者临床资料。其中,男性96例,女性23例,平均年龄(28±13)岁。119例供者中,父亲供肾52例,母亲供肾67例,平均年龄(51±13)岁。119例受者均于2010年10月行群体反应性抗体(PRA)检测,并于2014年10月至12月检测肾功能,观察受者抗HLA抗体、供者年龄和性别对移植肾功能的影响。采用χ2检验比较上述指标,P<0.05为差异有统计学意义。结果 119例受者中,28例产生抗HLA抗体,其中26例移植肾功能下降,占92.9%;无抗HLA抗体的91例受者中32例移植肾功能下降,占35.2%,差异有统计学意义(χ2=26.26,P<0.05)。父亲供肾与母亲供肾移植术后肾功能下降的受者比例分别为38.5%(20/52)和59.7%(40/67),差异有统计学意义(χ2=4.47,P<0.05)。119例供者中,81例年龄≥50岁,对应受者中41例肾功能下降(50.6%,41/81);38例供者年龄<50岁,对应受者中17例肾功能下降(44.7%,17/38);不同年龄供者供肾移植术后出现肾功能异常的受者比例差异无统计学意义(χ2=0.018,P>0.05)。结论父母供肾的亲属活体肾移植中,抗HLA抗体是肾功能下降的重要影响因素,供者性别也可能与术后肾功能下降有关。
Objective To study the influence of parents donation on long-term survival of renal allograft in living relative transplantation. Methods We retrospectively analyzed 119 recipients（ 96 males and 23 females）,aged（ 28 ± 13） years,who survived more than five years after parents donor kidney transplantation in Beijing Friendship Hospital. Panel reactive antibodies were detected in October 2010,and renal functions were detected between October and December,2014. Influence of anti-HLA antibodies,donor age and gender on renal function were observed. Chi-square test was used to compare these above indexes. P〈0. 05 was considered statistically significant. Results Twenty-six cases（ 92. 9%） of 28 recipients with anti-HLA antibodies positive were renal allograft dysfunction.However,thirty-two cases（ 35. 2%） of 91 recipients with anti-HLA antibodies negative were renal allograft dysfunction. Difference of the proportion of renal allograft dysfunction between the anti-HLA positive and negative group was statistically significant（ χ2= 26. 26,P〈0. 05）. There was significant difference of proportion of renal dysfunction between recipients received father and mother＇ s kidney（ χ2= 4. 47,P〈0. 05）. In 119 cases of donors,there were 81 cases aged ≥ 50 years with 41 cases ofrenal allograft dysfunction（ 50. 6%,41 /81）. There were 38 cases of donor aged 50 years with 17 cases of renal allograft dysfunction（ 44. 7%,17 /38）. Difference of postoperative renal allograft dysfunction proportion in different ages groups was not significant（ χ2= 0. 018, P〈0. 05）.Conclusions Anti-HLA antibody is an important factor in renal allograft dysfunction after parents donation kidney transplantation. Donor gender may also be associated with postoperative renal allograft dysfunction.
出处
《中华移植杂志（电子版）》
CAS
2015年第4期178-181,共4页
Chinese Journal of Transplantation(Electronic Edition)
基金
国家火炬计划项目(2014GH010024)
关键词
肾移植
亲属
群体反应性抗体
Renal Transplantation
Relatives
Panel reactive antibody
