The serum level of de novo donor specific antibody can predict acute rejection in lung transplantation.

肺移植(LTX)后急性排斥反应的诊断尚无有效的生物标志物用于临床。在这项研究中，我们分析了我们的活体供者叶LT患者的新生供体特异性同种异体抗体(DSA)的日常变化，以确定DSA水平是否受到急性排斥反应的影响。分析了10例非致敏患者接受两个人活体供体LTX的情况。其中5例在移植后14天内发生单侧急性排斥反应(AR组)，其余均未发生排斥反应(AR组)。采用流式细胞术交叉配型技术检测供者特异性IgM，每日监测供者两侧T细胞的免疫反应性。AR组供者两侧血清特异性IgM水平的差异显著高于AR组(p&lt；0.05)。在AR组中，排斥供者的IgM水平从临床急性排斥发作前两天开始显著高于非排斥供者(p&lt；0.05)。只有在急性排斥临床发作之前，排斥供者的免疫反应性才更强。供体特异性IgM序贯监测有助于急性排斥反应的早期诊断。

There is no useful biomarkers for diagnosis of acute rejection have been clinically used after lung transplantation (LTx). In this study, daily transition of de novo donor-specific alloantibodies (DSA) was analyzed for our living-donor lobar LT ecipients to determine whether DSA levels are influenced by acute rejection. Ten non-sensitized patients who had received living donor lobar LTx by donation from two individuals were analyzed. Five of them developed unilateral acute rejection during the first 14 days after transplantation (AR+ group), and the others had no rejection episode during the period (AR- group). The immunoreactivity against T-cells from each side of donors was daily monitored by detecting donor-specific IgM using flow cytometry crossmatch technique. The difference between donor-specific IgM levels of serum from each side of donors was more remarkable in the AR+ group than in the AR- group (p<0.05). In the AR+ group, the IgM levels against the rejected donors started to be significantly higher than that ageinst he non-rejected donors from two days before the clinical onset of acute rejection (p<0.05). A greater immunoreactivity only for the rejected donor preceded the clinical onset of acute rejection. Sequential de novo donor-specic IgM monitoring can contribute the early diagnosis of acute rejection.