南方医科大学学报

南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (03): 383-.

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肾移植术后供受者MICA抗体对早期移植肾功能的影响

付绍杰，刘如敏，罗敏，杜传福，王亦斌，徐健，肖露露，于立新   

  • 出版日期:2014-03-20 发布日期:2014-03-20

Effect of donor and recipient anti-MICA antibodies on early renal graft function
following transplantation

  • Online:2014-03-20 Published:2014-03-20

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摘要： 目的探讨供受者主要组织相容性复合物I 类相关链A（MICA）抗体对肾移植术后早期移植肾功能的影响。方法采用
Luminex200液相芯片技术，对43对肾移植供受者进行MICA抗体检测，其中26例尸体供者，所对应的43例受者。分为四组：
（1）供受者均为MICA抗体阳性组；（2）供者MICA抗体阳性、受者MICA抗体阴性组；（3）供者MICA抗体阴性、受者MICA抗体
阳性组；（4）供受者均为MICA抗体阴性组。比较各组之间术后急性排斥反应（AR）发生率、1周时血肌酐水平、移植肾功能恢复
时间等资料，分析供受者MICA抗体对早期移植肾功能的影响。结果26例尸体供者中MICA抗体阳性者5例（19.2%），抗体特
异性频率最高的是MICA*019（40%）；43 例受者中MICA 抗体阳性者11 例（25.6%），抗体特异性频率最高的是MICA*018
（14.6%）。43例受者肾移植后AR分析显示，第1组未发生AR（0/1）；第2组AR发生率为33.3%（2/6），第3组AR发生率为40%
（4/10）；第4组AR发生率为38.4%（10/26）。各组之间AR发生率无统计学意义（P>0.05）；各组在术后1周时血肌酐水平以及移
植肾功能恢复时间方面无统计学意义（均P>0.05）。结论供受者任何一方在肾移植前存在MICA抗体对术后早期受者的AR发
生率和肾功能恢复无明显影响。

Abstract: Objective To investigate the effects of donor and recipient anti-major histocompatibility complex class I-related
chain A (MICA) antibodies on early renal graft function in renal transplant recipients. Methods Using Luminex200 liquid chip
technology, we detected anti-MICA antibodies in 26 deceased donors paired with 43 recipients. We divided the 43 pairs into 4
groups according to different donor and recipient anti-MICA antibody positivity statuses and compared the incidence of acute
rejection (AR), serum creatinine at 1 week after transplantation, and renal function recovery time between the groups to assess
the effect of donor and recipient anti-MICA antibodies on early graft function. Results Five of the 26 donors were positive for
anti-MICA antibodies (19.2%), with the most common antibody being anti-MICA*019 (40%); 11 of the 43 recipients were
positive for anti-MICA antibodies (25.6%), among which anti-MICA*018 was most frequently found (14.6%). AR did not occur
in the only anti-MICA antibody-positive recipient receiving an anti-MICA antibody-positive donor graft; AR occurred in 2
(33.3%) of the 6 anti-MICA antibody-negative recipients receiving anti-MICA antibody-positive donor graft, in 4 (40%) out of
the 10 anti-MICA antibody-positive recipients receiving anti-MICA antibody-negative donor graft, and in 10 (38.4%) of the 26
anti-MICA antibody-negative recipients receiving anti-MICA antibodies-negative donor graft. The incidences of AR were not
significantly different between the groups (P>0.05), nor were serum creatinie levels or renal function recovery time at one week
after surgery(P>0.05). Conclusion Donor or recipient anti-MICA antibody positivity does not seem to significantly affect the
incidence of AR or renal function recovery early after transplantation to justify the necessity of monitoring donor anti-MICA
antibodies. But still, large-sample studies are needed to further investigate the potential impact of donor and recipient
anti-MICA antibodies on the outcomes of renal transplantation.