预处理对ABO血型不相合肾移植受者免疫功能的影响

doi:10.3969/j.issn.1006-298X.2019.03.003

肾脏病与透析肾移植杂志 ›› 2019, Vol. 28 ›› Issue (3): 213-218.DOI: 10.3969/j.issn.1006-298X.2019.03.003

预处理对ABO血型不相合肾移植受者免疫功能的影响

出版日期:2019-06-28 发布日期:2019-07-23

Preconditioning regimens on immune status of ABO incompatible kidney transplant recipients

Online:2019-06-28 Published:2019-07-23

摘要/Abstract

摘要：

目的：探讨预处理对ABO血型不相合（ABOi）肾移植受者免疫状态的影响。
方法：本研究纳入2018年3月至2018年9月在华西医院接受ABOi活体肾移植的9例受者及同时期ABO血型相合（ABOc）肾移植受者18例，收集和比较两组受者在预处理前后、移植前后T细胞（CD3+、CD4+、CD8+细胞）、B细胞计数（CD19+CD5+）、细胞因子[白细胞介素2(IL2)受体、IL6、IL8、肿瘤坏死因子α(TNFα)]、免疫球蛋白（IgG、IgA、IgM、IgE、IgG4）和补体（C3、C4、备解素因子B）水平。
结果：ABOi组受者在移植后7d、14d及1个月时外周血B细胞计数均显著低于ABOc组受者（256±240 cell/μl vs 34206±21659 cell/μl，P<0001；1167±1902 cell/μl vs 27342±22107 cell/μl，P=0002；150±173 cell/μl vs 36375±38582 cell/μl，P=003）；ABOi组受者术后7d IgG、IgA及IgM水平显著低于ABOc组（690±175 g/L vs 1018±250 g/L，P=0002；1 35555±50211 mg/L vs 2 16944±71971 mg/L，P=0006；65044±34008 mg/L vs 1 00883±44815 mg/L，P=004）；两组受者血清肌酐和估算的肾小球滤过率(eGFR)无差异。随访期间没有患者死亡、移植肾丢失、排斥反应及感染的发生。
结论：ABOi肾移植受者外周血B细胞显著减少，IgG、IgA及IgM水平短暂下降，但T细胞、细胞因子及补体水平并不受ABOi的影响，ABOi肾移植未增加受者短期内排斥和感染等的风险。

关键词: ABO血型不相合, 活体肾移植, 个体化预处理, 免疫状态

Abstract:

Ｏｂｊｅｃｔｉｖｅ：To investigate the impact of ABOincompatible（ABOi） living donor kidney transplantation and preconditioning regimens on the immune state of recipients.
Ｍｅｔｈｏｄｏｌｏｇｙ：Nine ABOi living donor kidney transplant recipients and eighteen ABO compatible （ABOc） recipients in our center between March 2018 and September 2018 were included in this study. We prospectively collected and compared the count of T cell subgroups (CD3+,CD4+,CD8+ cells),the count of B cells and the level of cytokines (IL2 receptor,IL6,IL8,TNFα),immunoglobulin (IgG,IgA,IgM,IgE,IgG4) and complement (C3,C4 and properdin B) before and after the pretreatment and transplantation.
Ｒｅｓｕｌｔｓ：The count of B cells in peripheral blood at 7 day,14 day and 1 month after transplantation in ABOi recipients was significantly lower compared to ABOc recipients. The levels of IgG,IgA and IgM at 7 day after transplantation in ABOi recipients were lower than those in ABOc recipients. There was no difference in the serum creatinine and eGFR after transplantation between both groups. During the followup period,no patients died and there was no case of graft loss,rejection and infection.
Ｃｏｎｃｌｕｓｉｏｎ：
The count of B cells in peripheral blood in ABOi kidney transplant recipients was significantly lower,and there was a temporary decline in IgG,IgA and IgM.However,ABOi transplantation didn′t impact the change of T cells,cytokines and complements. ABOi kidney transplantation don′t increase the shortterm occurrence of rejection and infection in recipients.

王显丁,刘金鹏,李亚梅,等. 预处理对ABO血型不相合肾移植受者免疫功能的影响[J]. 肾脏病与透析肾移植杂志, 2019, 28(3): 213-218.

WANG Xianding,LIU Jinpeng,LI Yamei, et al . Preconditioning regimens on immune status of ABO incompatible kidney transplant recipients[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, 2019, 28(3): 213-218.

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ISSN 1006-298X CN 32-1425/R

预处理对ABO血型不相合肾移植受者免疫功能的影响

Preconditioning regimens on immune status of ABO incompatible kidney transplant recipients

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