【摘要】 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。更多还原

【Abstract】 Objective:To explore the mechanism of early renal allograft loss and HLA humoral sensitization in first cadaveric kidney recipients.Methods:The serum panel reactive antibody(PRA)levels among three cases of renal allograft loss were detected by LAT-ELISA assay before one week and after one month transplantation respectively.The specificity and type of antibodies(IgG) were determined by LAT1240 software.Results:The serum PRA levels of HLA class Ⅰantibodies in one female were 17.86 %, and the specificity and type of antibodies was B60 before one week transplantation. but these were 39.29 % in one month after operation. Propert of HLA class Ⅰantibodies was B17. As to two males, the serum PRA level was negative (positive ratios<10%) one week pretransplant, but the PRA positive ratios were 46.43 %, 41.67 % in HLA Ⅰclass antibodies; positive ratios of the specific antibody response against HLA class Ⅱantigens in terms of PRA value were 25.00 %, 23.08 % in one month posttransplant respectively. and HLA antibody specificities were mainly B63,B22,DR53.Conclusions:According to donor specific antibodies,graft loss is an important risk factor to HLA humoral sensitization recipients of renal allograft.更多还原