Predictive value of HLA antibodies and serum creatinine in chronic rejection: Results of a 2-year prospective trial
Predictive value of HLA antibodies and serum creatinine in chronic rejection: Results of a 2-year prospective trial
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DOI：
10.1097/01.tp.0000174338.97313.5a
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发表时间：
2005-11-15
期刊：
影响因子：
6.2
通讯作者：
Ozawa, M
中科院分区：
文献类型：
--
作者：
Terasaki, PI;Ozawa, M
在这项大型合作研究中，对2,231名肾功能正常的移植患者进行了HLA抗体检测，然后在2年后检查了移植物存活率。在478例有抗体的患者中，15.1%在2年内失败，而在1,753例无抗体的患者中，失败率为6.8%（P= 0.0000002）。细胞毒性试验与结果的相关性优于流式细胞术或HLA包被珠的ELISA试验，可能是因为它检测到非HLA抗原。当患者进一步细分为血清肌酐0.5-1.9时，4.4%的抗体患者在2年时失败，而无抗体患者为4.3%。在血清肌酐值为2.0 - 2.9至17.9%的患者中，以及在3.0-3.9至16.3%的患者中，0.1%的差异增加。我们的结论是，HLA抗体移植后是随后的移植失败的预测，其预测价值可以提高患者血清肌酐值较高。
In this large collaborative study, 2,231 transplanted patients with functioning kidneys were tested for HLA antibodies, then examined 2 years later for graft survival. Among 478 patients with antibodies, 15.1% failed in 2 years, compared to 6.8% failure in 1,753 patients without antibodies (P=0.00000002). Cytotoxicity testing correlated better with outcome than flow cytometry or ELISA testing on HLA coated beads, possibly because it detected non-HLA antigens. When the patients were further broken down into those with serum creatinine at the time of testing of 0.5-1.9, 4.4% of antibody patients failed at 2 years, compared to 4.3% of patients without antibodies. This 0.1% difference increased among patients with serum creatinine values of 2.0 -2.9 to 17.9%, and among those with 3.0-3.9 to 16.3%. We conclude that HLA antibodies posttransplantation is predictive of subsequent graft failure, and its predictive value can be enhanced among patients with higher serum creatinine values.