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目的研究肾移植患者术前输血导致抗-HLA生成的几率。方法 2002年4月～2006年12月采用ELISA法共检测了1 810名肾移植患者肾移植前群体反应性抗体(PRA),并鉴定了抗体类型。1 810名患者中男性1 089人,女性721人。年龄19～62岁。其中单纯输血患者509例,男性185例,女性324例;721名女性患者中输血+妊娠的有235例。结果移植前输血患者509例,88例PRA阳性,占输血人数的17.28%,其中男性患者22例,占4.32%,女性患者66例,占12.97%。输血+妊娠患者235例,PRA阳性患者有64例,占输血+妊娠患者27.23%。肾移植术前输血患者PRA出现频率较高的抗-HLAⅠ类有抗-HLA-A1、A2、A3、A11和A24;抗-HLA-B13、B27、B60、B22、B51和B17。抗-HLAⅡ类在输血患者中未能检测出较高反应抗体。结论肾移植术前输血可导致抗-HLA的生成,而曾妊娠+输血的肾移植术前输血患者PRA产生的几率大于单纯输血的患者。
Objective To investigate the preoperative blood transfusions in renal transplant patients leading to the development of anti-HLA. Methods From April 2002 to December 2006, a total of 11 810 renal allograft recipients were tested for PRA by ELISA and the antibody type was identified. Of the 810 patients, 1,089 were male and 721 were female. Age 19 ~ 62 years old. Of these, 509 were transfusion-only patients, 185 were men and 324 were women; 235 were blood transfusions + pregnancies in 721 women. Results There were 509 transfused patients and 88 PRA positives, accounting for 17.28% of the total number of transfusions, including 22 males (4.32%) and 66 female females (12.97%). Blood transfusion + 235 cases of pregnancy, PRA-positive patients in 64 cases, accounting for 27.23% of patients with blood transfusion + pregnancy. HLA-A1, A2, A3, A11 and A24 anti-HLA-B13, B27, B60, B22, B51 and B17 were found in anti-HLA class I patients with higher preemptive PRA transfusion. Anti-HLA class II failed to detect higher reactive antibodies in transfused patients. CONCLUSIONS: Transfusion of blood prior to renal transplantation leads to the generation of anti-HLA, whereas PRA in transfusions prior to renal transplantation with gestational + transfusions is greater than in transfused patients.