摘要
目的 研究肾骨髓联合移植与嵌合体发生及急性排斥反应的关系。方法 采用供体骨髓与肾脏联合移植 ,进行 2 4例造血干细胞微嵌合体诱导 ,采用聚合酶链反应 (PCR)技术检测受者嵌合状态 ,与单纯肾脏移植组 37例比较嵌合发生率及急性排斥反应发生率。结果 随访 1年 ,肾骨髓联合移植组术后嵌合体发生率 (87 5 % ,2 1/ 2 4 )明显高于单纯肾脏移植组 (40 5 % ,15 / 37) ,差异有显著意义 (P 0 0 0 1) ;嵌合阳性组急性排斥反应发性率 (19 4 % ,7/ 36 )与嵌合阴性组 (44 % ,11/ 2 5 )相比差异有显著意义 (P <0 0 5 )。结论 肾骨髓联合移植可诱导嵌合体发生并增加受者对供体器官的免疫耐受 ,降低急性排斥反应发生率 。
Objective To evaluate the effect of donor-specific bone marrow cell infusion on the production of chimerism and acute rejection in kidney transplantation Methods Sixty-one patients, 48 males and 13 females, aged 38 4 (23-45), underwent transplantation of cadaveric kidneys, 24 of which underwent kidney transplantation combined with donor-specific bone marrow cell infusion and 37 of which underwent pure transplantation of kidney During the kidney transplantation combined with donor-specific bone marrow cell infusion the donor bone marrow cells (DBMC) were isolated from the thoracic vertebrae and iliac bones of the donors-cadavers and infused into the recipients of the kidneys of the same donors After operation the peripheral blood was collected from the 61 recipients every 2-3 months for at least 1 year to undergo PCR to detect the presence of chimerism, and the rates of chimerism and acute rejection were compared between these 2 groups Results During the follow-up the presence rate of chimerism was 87 5% (21/24) in the marrow recipients, significantly higher than that in the control group (40 5%, 15/37, P <0 001) The prevalence of acute rejection in the chimerism positive patients was 19 4% (7/16), significantly lower than that in the chimerism negative patients (44%, 11/25, P <0 05) Conclusion Donor-specific bone marrow cell infusion in cadaver kidney transplantation induces the production of chimerism, and increases the immune tolerance to the donor organs, thus finally decreasing the incidence of acute rejection Chimerism is correlated with immune tolerance
出处
《中华医学杂志》
CAS
CSCD
北大核心
2004年第23期1983-1985,共3页
National Medical Journal of China
基金
吉林省科技厅科研基金资助项目 (2 0 0 3 0 5 3 7 1)
关键词
肾移植
骨髓移植
嵌合体
移植物排斥
Kidney transplantation
Bone marrow transplantation
Chimera
Graft rejection
