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Akım Sitometrisi ile Böbrek Nakli Sonrası Vericiye Özgü Antikorların Monitorizasyonu

Flow Cytometry Monitoring of Donor Specifi c Antibodies after Kidney Transplantation

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2010
DOI: 
doi: 10.5262/tndt.2010.1002.64

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
OBJECTIVE: In this study, we purpose that the screening of posttransplant donor spesifi c antibodies (DSA) and target of these antibodies by fl ow-cytometry. We also try to investigate that the relationship with the DSA’s and the graft survival. MATERIAL and METHODS: Fifty renal transplant patients and their related donors were included to study. Serum samples were taken 1., 7.,14. days and 1., 3., 6 and 12. posttransplant months. T and B cell fl ow cytometric cross-match tests were performed with the donor derived fresh cells. RESULTS: We determined as positive FCXM results of postransplant 1., 7., 14. days as 16%, and 1., 6., 9. and 12. months 18%, 14%, 12% and 12% respectively. While 5 patients results are positive in whole study time, 6 patients results were positive different test days. Two of fi ve patients who had whole study days FCXM positive lost their allografts due to acute rejection episodes in posttransplant secod and third day. Chronic allograft dysfuntion was occured in three of 6 patients who had FCXM positive (B cell FCXM positive) in the different day. Two patients lost their grafts during the study period. Graft survival was found 96% and 96% in 6 and 12 months respectively. There was a relationship between the test days creatinine levels and FCXM results. CONCLUSION: As a result; while positive results of B and T cell FCXM in whole study days are related with the acute rejection and graft survival but there is no relationship with chronic rejection. It was also found that no relationship between the only T cell positive FCXM and acute rejection, graft survival and chronic rejection. In the fi rst posttransplant month, the relationship between positive B cell FCXM tests and chronic rejection were found statistically signifi cant. It is shown that the posttransplant B and T cell FCXM and fi rst month B cell FCXM tests are predictive for acute rejection, graft survival and chronic rejection respectively. Permanent and intermittent FCXM positivity were not found related with acute rejection and graft survival. The creatinine levels of patients with FCXM positivity were found to be higher than the patients with FCXM negative.
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Abstract (Original Language): 
AMAÇ: Bu çalışmada, akım sitometrisi ile çaprazlama (ASCM) yöntemi ile saptanan vericiye özgü antikorların oluşumu, bu antikorların hedef hücresi ve devamlılığı ile rejeksiyon, graft sağkalımı arasındaki ilişkinin değerlendirilmesi amaçlanmıştır. GEREÇ ve YÖNTEMLER: Çalışmaya böbrek nakli olmuş 50 hasta ve onların akraba vericileri dahil edilmiştir. Nakil sonrası 1., 7., 14. gün ve 1., 3., 6. ve 12. aylarda hastalardan serum elde edilerek vericilerin taze hücreleri ile T ve B ASCM uygulanmıştır. BULGULAR: Nakil sonrası yapılan test sonuçları değerlendirildiğinde, 1., 7. ve 14. gün testlerinin, 8 (%16)’inin, 1. ay 9 (%18)’unun, 3. ay 7 (%14)’sinin, 6. ay ve 12. ay 6 (%12)’sının pozitif olduğu saptanmıştır. Hastalardan 5’inin tüm çalışma süresince ASCM sonuçları (+) iken, 6 hastanın farklı test günlerinde sonuçlarının (+) olduğu saptanmıştır. Tüm çalışma süresince ASCM sonuçları (+) olan 5 hastadan 2’si (her ikisinde de tüm çalışma günlerinde T, B +) akut rejeksiyon sonucu böbreklerini kaybetmişler. Farklı test günlerinde (+) olan 6 hastanın 3’ü (3 hastanın sonucu da B ASCM +) kronik rejeksiyon nedeniyle takip edilmektedir. Çalışma süresince 2 hasta graftlarını kaybetmiştir. Altı aylık ve 1 yıllık graft sağkalımı %96 olarak saptanmıştır. Ayrıca, hastaların test günlerindeki kreatininin düzeyleri ile ASCM (+) ve (-) sonuçlar arasında ilişki bulunmuştur. SONUÇ: Nakil sonrasında ASCM testi yaptığımız tüm günlerde elde edilen test sonuçlarını hedef hücrelerin pozitifl iğine göre değerlendirdiğimizde; T,B ASCM (+) sonuçların tüm çalışma günlerinde, akut rejeksiyon ve graft sağkalımı, ile ilişkisi istatistiksel açıdan anlamlı iken, bu kronik rejeksiyon ile anlamsız bulunmuştur. Nakil sonrası ilk 1 ay içindeki B ASCM (+) sonuçların ise, kronik rejeksiyon ile ilişkisi istatistiksel açıdan anlamlıdır. Nakil sonrası tüm test günlerinde saptanan T, B ASCM (+) sonuçların akut rejeksiyon ve graft sağkalımı konusunda, ilk 1 ay içindeki tüm B ASCM (+) sonuçların ise, kronik rejeksiyon konusunda kliniğe ışık tutabileceği görülmektedir. ASCM (+) olan hastaların devamlı ve aralıklı test günlerindeki pozitifl ik ile rejeksiyon ve graft sağkalımı arasındaki ilişki istatistiksel açıdan anlamsız bulunmuştur. ASCM (+) olan hastaların kreatinin düzeylerinin ortalaması ASCM (-) olan hastalardan daha yüksek olarak bulunmuştur.
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  • Turkish

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