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1、HLA抗体对肝移植术后急性排斥发生的影响作者：陈伟1；陈规划2；陆敏强2；杨扬2；蔡常洁2；侯宝华2；林叶2；张伟东3；肖露露3 (1广东省人民医院肝胆外科，广东广州 510080；2中山大学附属第三医院器官移植研究所肝脏移植中心，广东广州 510630；3广州器官移植配型中心，广东广州 510095)摘要：目的探讨肝移植手术前后HLA抗体变化对移植肝脏急性排斥的影响。方法134例患者接受改良背驮式肝移植，分别于手术前、手术后第1、7、14、30日通过酶联免疫吸附(ELISA)法检测HLA抗体，通过B超引导下肝穿刺病理检查明确有无急性排斥，观察肝
2、移植前后HLA抗体变化对急性排斥发生的影响。结果术前HLA抗体阳性组急性排斥发生率(56.8%)显著高于术前HLA抗体阴性组(25.9%)(P=0.001)；术前HLA抗体阴性而术后转为阳性组急性排斥发生率与术前术后HLA抗体均为阴性组有显著差异(P=0.003)。结论患者术前HLA抗体阳性可能是引起肝移植术后急性排斥的原因之一，患者术后HLA抗体持续阳性与急性排斥的发生密切相关。关键词：肝移植;HLA抗体;急性排斥反应中图分类号：R657.3 文献标识码：A 文章编号：1673-4254(2006)06-0774-03EffectsoftheHLA
3、antibodiesonallograftacuterejectionaftercadavericlivertransplantationCHENWei1；CHENGui-hua2；LUMin-qiang2；YANGYang2；CAIChang-jie2；HOUBao-hua1；LINYe1；ZHANGWei-dong3；XIAOLu-lu31DepartmentofHepatobiliarySurgery,People’sHospitalofGuangdongProvince,Guangzhou510080,China;2LiverTransplant
4、ationCenter,InstituteofOrganTransplantation,ThirdAffiliatedHospitalofSunYat-senUniversity,Guangzhou510630,China;3GuangzhouTissueTypingCenter, Guangzhou 510095,ChinaAbstract:ObjectiveToevaluatetheeffectofperioperativeHLAantibodychangesonacuteallograftrejectionincadavericlivertra
5、nsplantation.MethodsTotally134patientsreceivedmodifiedpiggybacklivertransplantationandenzyme-linkedimmunosorbentassaywasperformedforHLAantibodydetectionbeforeandthe1,7,14and30daysafteroperation.Bultrasound-guidedliverbiopsywasemployedfordiagnosisofacuteallograftrejection,andthepe
6、rioperativechangesofHLAantibodieswereevaluatedfortheireffectonallograftacuterejection.ResultsOfthe44recipientswithpreoperativepositivityforHLAantibodies,acuterejectionoccurredin56.8%ofthepatients,ascomparedwith25.9%inthosenegativeforHLAantibody(P=0.001).Thepatientswhobecamepositi
7、veforHLAantibodypostoperativelyhadarateofacuterejectionof60%,whichwassignificantlyhigherthanthatinthosepersistentlynegativeforHLAantibody(18.6%,P=0.003).ConclusionHLAantibodypositivitybeforetransplantationmaycontributetoacuterejectionepisodeinlivertransplantation,andpersistentpos
8、ttransplantHLAantibodypositivityisclosel
