MEDLINE/PubMed Journal Browser Search

Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

Title: [Relationship of distribution frequency of HLA antigen/antibody and PIRCHE score with DSA production and AMR occurrence].
Author: Zheng J, Kuang PD, Zhang Y, Zhao Q, He XL, Ding XM, Xue WJ.
Journal: Zhonghua Yi Xue Za Zhi; 2019 Mar 26; 99(12):901-906. PubMed ID: 30917438.
Abstract:
Objective: To analyze the distribution frequency of HLA antigen gene and antibody, and explore the relationship of PIRCHE score with DSA production and AMR occurrence. Methods: Kidney transplantation cases of department Kidney transplantation, the First Hospital of Xi'an Jiaotong University from November 2013 to June 2017 were included in our study. HLA high resolution typing were detected with LAB Type (TM) SSO method. HLA classⅠ & Ⅱ antibody detection were tested by LAB screen Single Antigen beads with Luminex 200 technology. PIRCHE score were graded with PIRCHE score system. Results: HLA high resolution classification data of 798 recipients and 409 donors showed that HLA A2, A11, A24 were common in HLA A locus; HLA B46, B51 B60, B35, B62, B61 were common in HLA B locus; HLA DR9, DR4, DR15, DR12, DR7, DR11 were common in HLA DR locus; HLA DQ7, DQ6, DQ5, DQ9, DQ2 were common in HLA DQ locus. The positive cases of HLA class Ⅰ & Ⅱ antibody and DSA were 105, 40 and 32, respectively. The most common of HLA class Ⅰ antibody were A24 and B7 antibody; the most common of HLA class Ⅱ antibody was DQ antibody, including DQ2, DQ9, DQ4, DQ6, DQ7 and DQ8. PIRCHE scores of living donor transplantation recipients were significantly lower than DCD group (P<0.01). PIRCHE score of DSA(+) and DSA(+)AMR(+) group were markedly higher than that of DSA(-)and DSA(+)AMR(-)group, respectively(P<0.05); analysis of ROC curve on PIRCHE scores could predict DSA production and AMR occurrence. The AUC for prediction DSA production was 0.80, and the critical value was 115.5. For prediction of AMR, the AUC was 0.89 and the critical value was 133.5. Conclusions: The common HLA antigens have stronger immunogenicity, and easy to stimulate the body to produce HLA antibodies; matching of common antigen sites and HLA class Ⅱ antigen should be attached importance before kidney transplantation. PIRCHE score can predict the generation of DSA and the occurrence of AMR effectively. PIRCHE score for HLA match, is more sensitive than traditional methods, and contains more information. 目的： 分析肾移植供受者人类白细胞抗原（HLA）分布频率与受者HLA抗体分布频率，揭示预测间接可识别的HLA表位（PIRCHE）评分与供者特异性抗体（DSA）的产生和抗体介导排斥反应（AMR）发生的关系。 方法： 选取西安交通大学第一附属医院肾移植科2013年11月至2017年6月798例肾移植病例。采用HLA高分辨分型LABType(TM) SSO法，HLAⅠ、Ⅱ类抗体检测采用LABcreen Single Antigen试剂，Luminex 200技术进行检测。PIRCHE评分系统进行PIRCHE评分。 结果： 798例受者，409例供者的HLA高分辨分型资料结果显示，常见供受体HLA A位点以A2、A11、A24最为常见；B位点以B13、B46、B51、B60、B35、B62、B61最为常见；DR位点以DR9、DR4、DR15、DR12、DR7、DR11最为常见；DQ位点以DQ7、DQ6、DQ5、DQ9、DQ2最为常见。术后HLAⅠ类抗体阳性105例，HLAⅡ抗体阳性40例，DSA阳性32例。HLAⅠ类抗体最常见为A24，B7抗体；HLA Ⅱ类抗体最常见为DQ抗体，包括DQ2，DQ9，DQ4，DQ6，DQ7，DQ8。活体移植供受者PIRCHE评分低于DCD供肾组（P<0.01），差异有统计学意义；DSA(+)组及DSA(+)AMR(+)组PIRCHE评分分别高于DSA(-)组及DSA(+)AMR(-)组（P<0.01），差异有统计学意义；ROC曲线对PIRCHE评分预测DSA产生及AMR发生进行了分析发现，DSA产生的AUC为0.80，临界值为115.5；AMR发生的AUC为0.89，临界值为133.5。 结论： 常见的HLA抗原，免疫原性强，容易刺激机体产生HLA抗体；肾脏移植前应重视常见抗原位点的匹配以及HLAⅡ抗原的匹配。PIRCHE评分用于HLA配型，可有效预测DSA的产生和AMR的发生，具有比传统方法更灵敏，包含信息量更大的优势。.

[Abstract] [Full Text] [Related] [New Search]