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Renal Transplant Alıcılarında Post-transplant anti-HLA Antikorların Sıklığı ve Risk Etkenleri

De-Novo anti-HLA Antibodies After Renal Transplantation: Prevalance and Risk Factors

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2011
DOI: 
DOI 10.5262/tndt.2011.1001.13

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
AIM : Development of de-novo anti-HLA antibodies in the post-transplant period might be the earliest finding of later chronic antibody mediated rejection. In this study, we aimed to investigate the incidence and risk factors of de-novo anti-HLA antibodies in our kidney allograft recipients. MA TERIAL and Metho ds: After exclusion, 91 (64M/27F) patients having functional graft and negative HLA antibody before the transplantation were taken into the analysis. Anti-HLA antibodies were evaluated by the Luminex method. Res ults : Duration of posttransplantation time was 38±31 months and the mean age was 38±10. Mean estimated glomerular filtration rate (GFR) was 68±19 ml/min, and the biopsy proven acute rejection rate was 15.2 %. Anti- HLA antibody was observed in 12 patients (13.1%). When the anti-HLA antibody positive group was compared with the negative group, estimated GFR (58±26 ml/min vs. 69±18 ml/ min, (p=0.05)), living donor/cadaveric donor (5/7 vs. 66/13 (p=0.004)), and acute rejection (6/12 (%50) vs. 8/79 (%10.1) (p=0.002)) were significantly different between the groups. Deceased donor and acute rejection were independent risk factors for development of anti-HLA antibody (p=0.008 and p= 0.004, respectively) on multivariate analysis. ConclusIo n: In conclusion, anti-HLA antibody can be seen after renal transplantation even in stable patients. Acute rejection and deceased donor transplantation are the major risk factors for development of anti-HLA antibodies.
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Abstract (Original Language): 
Amaç: Renal transplantasyon sonrasında kronik allograft nefropati (KAN) gelişiminde immünolojik ve immünolojik olmayan etkenler rol oynar. İmmünolojik etkenlerin başında de-novo oluşan anti- HLA antikorları ve buna bağlı kronik immün hasar gelmektedir. Bu çalışmada, renal transplantasyon sonrasında hastalarda de-novo anti-HLA antikor gelişimi ve bunu etkileyen etkenleri ortaya çıkarmayı amaçladık. GEREÇ ve YÖN TEML ER: Transplantasyon polikliniği izlenmesinde olan ve 6-120 ay nakil sonrası süreye sahip hastalar çalışmaya alındı. Transplantasyon öncesi anti-HLA antikorları olan hastalar çalışma dışı bırakıldılar. Anti-HLA antikorları Luminex yöntem ile değerlendirildi. Bulgular: Toplam 91 hasta (64 E, 27 K) analize alındı. Hastaların post-transplant izleme süreleri 38±31 ay ve ortalama yaşları 38±10 idi. Ortalama tahmini glomerüler filtrasyon hızı (GFH) 68±19 ml/dk idi. Biyopsi kanıtlı akut rejeksiyon %15,2 olarak saptandı. Yapılan incelemede toplam 12 hastada anti-HLA antikor varlığı ortaya kondu (%13,1). Anti-HLA antikorları olan ile olmayan grup karşılaştırıldığında sırasıyla; tahmini GFH 58±26 ile 69±18 ml/dk (p=0,05), canlı/kadavra 5/7 ve 66/13, (p=0,004), akut rejeksiyon 6/12 (%50) ve 8/79 (%10,1), (p=0,002) anlamlı risk etkenleri olarak saptandı. Yapılan çok değişkenli analizde her iki etkenin de HLA antikor gelişimi için bağımsız risk etkenleri (kadavradan transplantasyon [p=0,008], akut rejeksiyon [p= 0,004]) olduğu ortaya kondu. Sonuç: Sonuç olarak renal transplantasyon sonrası anti-HLA antikorları gelişimi nadir değildir. Kadavradan transplantasyon ve akut rejeksiyon anti-HLA antikorların gözlenmesinde en önemli risk etkenleridir.
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  • Turkish

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