Role of anti-A/B antibody titers in results of ABO-incompatible kidney transplantation
Role of anti-A/B antibody titers in results of ABO-incompatible kidney transplantation
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DOI：
10.1097/00007890-200011150-00011
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发表时间：
2000-11-15
期刊：
影响因子：
6.2
通讯作者：
Toma, H
中科院分区：
文献类型：
--
作者：
Shimmura, H;Tanabe, K;Toma, H
背景我们以往的研究表明，ABO血型不合的活体肾移植中体液排斥反应的发生率极高。提示抗A/B抗体滴度直接影响ABO血型不合肾移植的存活率。本文探讨术前抗A/B抗体滴度对ABO血型不合活体肾移植术后效果的影响。方法1989年1月至1995年12月，我院共行ABO血型不合活体肾移植术67例，男38例，女29例，平均年龄34.9岁。67例受者中的61例被纳入抗A/B抗体滴度对移植物长期存活的影响分析。其余6例患者因肾移植后1年内移植物功能正常死亡（3例）和非免疫原因停用免疫抑制剂（3例）而被排除。移植前最大IgG抗体水平低于1：16的移植物存活率（n = 21）在1、5和8年分别为81.0%、66.8%和66.8%。1：32-1：64（n = 33）和高于1：128（n = 7）的相应值分别为93，9，90，5，79，7%和42，9，28，6，28，6%（log-rank检验，P = 0，0007）。抗A/B IgM最大滴度、抗A/B IgM最小滴度、抗A/B IgG最小滴度与移植物存活率无显著相关性。术前最大抗AIS IgG滴度与ABO血型不合活体肾移植术后移植物长期存活相关因此，术前抗A/B IgG滴度的最高水平是ABO血型不合活体肾移植结果的良好预测指标之一。
Background. Our previous studies showed that the incidence of humoral rejection was extremely high in ABO-incompatible living kidney transplantation. This result suggests that anti-A/B antibody titers directly influence the graft survival of ABO-incompatible kidney transplantation. In this study, we examined the impact of preoperative anti-A/B antibody titers on the results of ABO-incompatible living kidney transplantation,Methods, Sixty-seven patients underwent ABO-incompatible living kidney transplantation at our institution between January 1989 and December 1995, The mean age was 34.9 years with 38 males and 29 females. Sixty-one of the 67 recipients were included in an analysis of the impact of anti-A/B antibody titer in longterm graft survival. The remaining six patients were excluded because of death with a functioning graft (three patients) and withdrawal of immunosuppression due to nonimmunological reasons (three patients) within 1 year after renal transplantation.Results. The graft survival rate for the level of less than 1:16 in maximum IgG antibody before transplantation (n = 21) at 1, 5, and 8 years was 81,0, 66,8, and 66,8%, respectively. The corresponding values for the level of 1:32-1:64 (n = 33) and higher than 1:128 (n = 7) were 93,9, 90,5, and 79,7%, and 42,9, 28,6, and 28,6%, respectively (log-rank test, P = 0,0007), There was no significant association between maximum anti-A/B IgM titers, minimum anti-A/B IgM titers, minimum anti-A/B IgG; titers, and graft survival.Conclusions. Preoperative maximum anti-AIS IgG titers correlated with the long-term graft survival in ABO-incompatible living kidney transplantation. Thus, preoperative maximum levels of anti-A/B IgG titers are one of the good predictors of the results of ABO-incompatible living kidney transplantation.