Four-year follow-up of a prospective trial of HLA and MICA antibodies on kidney graft survival
Four-year follow-up of a prospective trial of HLA and MICA antibodies on kidney graft survival
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DOI：
10.1111/j.1600-6143.2006.01644.x
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发表时间：
2007-02-01
影响因子：
8.8
通讯作者：
Castro, R.
中科院分区：
文献类型：
--
作者：
Terasaki, P. I.;Ozawa, M.;Castro, R.
2002年，在第13届国际组织相容性研讨会上，对1329名接受功能性移植的患者进行了前瞻性的人类白细胞抗原抗体检测。检测4年后，2002年，806名没有抗体的患者的已故供者移植物存活率为81%，相比之下，携带人类白细胞抗原抗体的158名患者的存活率为58%(p<；0.0001)，69名MICA抗体的患者的存活率为72%(p=0.02)。在第14期研讨会中，接受已故供者移植物和无人类白细胞抗原抗体的患者的存活率分别为96%和94%(P=0.0004)，而接受MICA的患者存活率为83%(P=0.0005)。多变量分析显示：人类白细胞抗原抗体为3.6%(p<；0.00001)，MICA为6.1%(p=0.006)。12名接受单一抗原珠检测的供者特异性抗体患者的1年存活率为%(p=0.008)，27名非供者特异性“强”抗体患者的1年存活率为66%(p=0.0003)，而没有抗体者的存活率为92%。总之，这两项经过1年和4年的前瞻性试验提供了强有力的证据，表明人类白细胞抗原和MICA抗体与移植物失败有关。
In 2002, 1329 patients with functioning transplants were prospectively tested for HLA antibodies in the 13th International Histocompatibility Workshop. Four years after testing, deceased donor graft survival among 806 patients not having antibodies in 2002 was 81% compared to 58% for 158 patients with HLA antibodies (p < 0.0001) and 72% for 69 patients with MICA antibodies (p = 0.02). Hazard ratio (HR) using death-censored graft survival from multivariate analysis of HLA antibodies was 3.3 (p < 0.00001) and 2.04 for MICA (p = 0.01).In the 14th Workshop, at 1 year follow-up, survival for 1319 patients receiving deceased donor grafts and no HLA antibodies was 96% compared to 94% for 344 patients with HLA antibodies (p = 0.0004) and 83% survival for 33 patients with MICA (p = 0.0005). HR from multivariate analysis: HLA antibodies was 3.6 (p < 0.00001) and 6.1 for MICA (p = 0.006). Twelve patients with donor specific antibodies tested by single antigen beads had a 1 year survival of 64% (p = 0.008), and 27 patients with non-donor specific 'strong' antibodies had a 66% survival (p = 0.0003) compared to 92% survival in those with no antibodies.In conclusion, these two prospective trials, after 1 and 4 years, provided strong evidence that HLA and MICA antibodies are associated with graft failure.