Systemic Complement Activation in Deceased Donors Is Associated With Acute Rejection After Renal Transplantation in the Recipient
Systemic Complement Activation in Deceased Donors Is Associated With Acute Rejection After Renal Transplantation in the Recipient
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DOI：
10.1097/tp.0b013e318222c9a0
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发表时间：
2011-07-27
期刊：
影响因子：
6.2
通讯作者：
Ploeg, Rutger J.
中科院分区：
文献类型：
--
作者：
Damman, Jeffrey;Seelen, Marc A.;Ploeg, Rutger J.
背景。肾移植后的急性排斥反应已被证明与移植的长期存活呈负相关。识别与受体急性排斥反应相关的供体因素有助于更好地理解导致移植物损伤的相关潜在过程。补体活化已被证明是肾移植相关损伤的重要介质。在本研究中，我们分析了肾脏移植前死亡供者的全身补体激活对受者移植后预后的影响。采用ELISA法对232例脑死亡和心死亡供者血浆中补体活化标志物C5b-9、C4d、Bb和补体成分甘露聚糖结合凝集素进行分析。在多元回归模型中分析这些参数与移植后受者预后的关系。研究发现，供体血浆中C5b-9水平与肾移植后第一年受者活检证实的急性排斥反应有关（P=0.035）。在脑死亡和心脏死亡的供体中均发现补体活化增加。总之，我们发现供体中的C5b-9与受体肾移植的急性排斥反应有关。供体的靶向补体激活是否可以改善受体的急性排斥反应还需要进一步研究。
Background. Acute rejection after renal transplantation has been shown to be negatively associated with long-term graft survival. Identifying donor factors that are associated with acute rejection in the recipient could help to a better understanding of the relevant underlying processes that lead to graft injury. Complement activation has been shown to be an important mediator of renal transplant related injury. In this study, we analyzed the effect of systemic complement activation in deceased donors before transplantation of their kidneys on posttransplant outcome in the recipient.Methods. Plasma from 232 deceased brain-dead and deceased cardiac-dead donors were analyzed for the complement activation markers C5b-9, C4d, Bb, and complement component mannan binding lectin by ELISA. The association of these parameters with posttransplant outcome in recipients was analyzed in a multivariate regression model.Results. It was found that C5b-9 level in donor plasma is associated with biopsy-proven acute rejection in the recipient during the first year after renal transplantation (P=0.035). Both in deceased brain-dead and deceased cardiac-dead donors increased complement activation was found.Conclusions. In conclusion, we found C5b-9 in the donor to be associated with acute rejection of renal transplants in the recipient. Whether targeting complement activation in the donor may ameliorate acute rejection in the recipient needs to be studied.