基因水平HLA-DR相容对移植肾急性排斥和存活率的影响

摘要

The effect of HLA-DR matching was retrospectively examined at DNA level on rejection and graft survival of cadaver renal transplantation. HLA-DR matching was typed by PCR-SSP technique in 318 cyclosporine-treated primary cadaveric renal recipients. The recipients were divided into three groups:no DR mismatching (0MM), one DR mismatching (1MM) and two DR mismatching (2MM). The effect of genomic HLA-DR compatibility on early kidney function, acute rejection, steroid pulses and 1 year graft survival was retrospectively analyzed. HLA-DR alleles in all samples were successfully genotyped by PCR-SSP. The overall time of DNA typing was 4 hours. The patients well-matched(0MM),moderately-matched(1MM) and poorly-matched(2MM) were 11.6%, 51.9% and 36.5%, respectively. The total rejection rate, 1 year patient survival and graft survival in 318 recipients were 49.1%, 94.3% and 90.3%. Early graft function, acute rejection episodes, steroid pulses and graft survival in well-matched recipients were better than those in poorly-matched patients. In particular, significant difference was found in acute rejection episodes and 1 year graft survival,suggesting genomic compatibility of HLA-DR has effect on acute rejection and graft survival in cadaver kidney transplantation.%回顾性分析基因水平 HLA-DR相容对移植肾急性排斥和存活率的影响。318例接受环孢菌素A治疗的首次尸肾移植，DR分型采用 PCR-SSP方法。分析DR相容对早期肾功能、急性排斥与激素治疗和1年存活率的影响。结果显示 HLA-DR基因分型均获成功，耗时4h。318例受者中达到0MM者占11.6%、1MM占51.9%、2MM占36.5%，总体排斥率49.1%，1年人/肾存活率94.3%、90.3%。DR相容者，早期肾功能、急性排斥与激素治疗、移植肾存活均明显优于配型差的受者，具有统计学差异。提示基因水平 HLA-DR相容对尸肾移植急性排斥和存活率具有重要影响。