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

目前临床上还没有诊断肺移植术后急性排斥反应的有用生物标志物。在这项研究中，我们分析了活体供体大叶肝移植受体的每日新生供体特异性同种抗体（DSA）的转变，以确定DSA水平是否受到急性排斥反应的影响。我们分析了10例接受两个人活体供体肺叶LTx的非致敏患者。5例患者在移植后14天内出现单侧急性排斥反应（AR+组），其余患者在移植后14天内未发生排斥反应（AR-组）。通过流式细胞术交叉配型技术检测供体特异性IgM，每天监测供体两侧对t细胞的免疫反应性。AR+组供体两侧血清特异性IgM水平差异显著（p<0.05）。在AR+组中，排斥供者的IgM水平在急性排斥临床发生前2天开始显著高于非排斥供者（p<0.05）。在急性排斥的临床发作之前，只有被排斥的供体有更大的免疫反应性。序次从头供体特异性IgM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.