Effects of Different Sensitization Events on HLA Alloimmunization in Solid Organ Transplantation Patients
Effects of Different Sensitization Events on HLA Alloimmunization in Solid Organ Transplantation Patients
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DOI：
10.1016/j.transproceed.2011.12.049
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发表时间：
2012-01-01
影响因子：
0.9
通讯作者：
Park, M. H.
中科院分区：
文献类型：
--
作者：
Hyun, J.;Park, K. D.;Park, M. H.
客观的。 HLA同种免疫是由各种致敏事件引起的，例如输血、妊娠或器官移植。然而，尚未使用相同的测试方法并行地很好地研究特定致敏事件对 HLA 同种免疫的影响。我们评估了不同的致敏事件如何影响实体器官移植候选者中的面板反应性抗体（PRA）状态。方法。使用 Luminex 检测试剂盒（LIFECODES, Gen-Probe, Stamford, CT, United States）对 674 名患者（354 名男性和 320 名女性）进行了 PRA 鉴定测试。根据不同致敏事件和性别，分析PRA阳性病例中PRA阳性率（中位荧光强度[MFI]值≥1000的HLA-A、B或DR抗体）和抗体强度。结果。发生输血 (33.0%; P = .001)、妊娠 (71.4%; P < .001) 或移植事件 (76.9%; P < .001) 的患者的 PRA（I 类和/或 II 类）阳性率显着高于没有任何可识别致敏事件的对照患者 (5.6%)。移植的免疫效果最强，特别是针对II类HLA抗原。女性与男性患者相比（60.3% vs 34.2%；P < .001）以及再移植与首次肾移植候选者相比（80.2% vs 41.1%；P < .001）显示出显着更高的 PRA 阳性率。再移植候选者 (MFI 14,164) 显示出比首次移植候选者 (MFI 5456) 和具有单一输血致敏事件 (MFI 4185) 或妊娠 (MFI 5548；P < .001) 的抗体强度显着更强的抗体强度。结论。实体器官移植似乎具有最强的 HLA 同种免疫效果，其次是妊娠和输血，特别是对于 II 类 HLA 抗原。
Objective. HLA alloimmunization is caused by various sensitization events, such as transfusion, pregnancy, or organ transplantation. However, the effects of a particular sensitization event on HLA alloimmunization have not been well studied in parallel using an identical test method. We evaluated how different sensitization events affect the panel-reactive antibody (PRA) status in solid organ transplantation candidates.Methods. PRA identification tests were performed on 674 patients (354 males and 320 females) using Luminex assay kits (LIFECODES, Gen-Probe, Stamford, CT, United States). PRA-positive rates (HLA-A, B, or DR antibodies of median fluorescence intensity [MFI] values of >= 1000) and antibody strengths in PRA-positive cases were analyzed according to the different sensitization events and gender.Results. PRA (class I and/or II) positive rates were significantly higher in patients with transfusion (33.0%; P = .001), pregnancy (71.4%; P < .001), or transplantation events (76.9%; P < .001) than in controls without any identifiable sensitization events (5.6%). Transplantation had the strongest immunization effect, especially for class II HLA antigens. Female compared with male patients (60.3% vs 34.2%; P < .001) and retransplantation compared with first transplantation candidates of kidney transplantation (80.2% vs 41.1%; P < .001) showed a significantly higher PRA-positive rate. Retransplantation candidates (MFI 14,164) showed significantly stronger antibody strength than first transplantation candidates (MFI 5456) and those with single sensitization events of transfusion (MFI 4185) or pregnancy (MFI 5548; P < .001 for each).Conclusion. Solid organ transplantation appears to have the strongest HLA alloimmunization effect followed by pregnancy and transfusion, especially for class II HLA antigens.