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T细胞多克隆抗体在公民逝世后器官捐献供肾肾移植中的效果分析

李杨 胡筱筠 丁晨光 刘尊伟 丁小明 项和立 田普训 郑瑾 薛武军

李杨, 胡筱筠, 丁晨光, 等. T细胞多克隆抗体在公民逝世后器官捐献供肾肾移植中的效果分析[J]. 器官移植, 2020, 11(5): 566-571. doi: 10.3969/j.issn.1674-7445.2020.05.006
引用本文: 李杨, 胡筱筠, 丁晨光, 等. T细胞多克隆抗体在公民逝世后器官捐献供肾肾移植中的效果分析[J]. 器官移植, 2020, 11(5): 566-571. doi: 10.3969/j.issn.1674-7445.2020.05.006
Li Yang, Hu Xiaoyun, Ding Chenguang, et al. Efficacy analysis of T lymphocyte polyclonal antibody in renal transplantation from donor kidney of organ donation after citizen's death[J]. ORGAN TRANSPLANTATION, 2020, 11(5): 566-571. doi: 10.3969/j.issn.1674-7445.2020.05.006
Citation: Li Yang, Hu Xiaoyun, Ding Chenguang, et al. Efficacy analysis of T lymphocyte polyclonal antibody in renal transplantation from donor kidney of organ donation after citizen's death[J]. ORGAN TRANSPLANTATION, 2020, 11(5): 566-571. doi: 10.3969/j.issn.1674-7445.2020.05.006

T细胞多克隆抗体在公民逝世后器官捐献供肾肾移植中的效果分析

doi: 10.3969/j.issn.1674-7445.2020.05.006
基金项目: 

国家自然科学基金 81970668

国家自然科学基金 81970670

陕西省自然科学基础研究计划项目 2019JM-116

详细信息
    作者简介:

    李杨, 男, 1981年生, 博士, 副研究员, 研究方向为肾移植, Email:jullian80915@126.com

    通讯作者:

    薛武军, 男, 1961年生, 博士, 主任医师, 研究方向为肾移植, Email:xwujun126@xjtu.edu.cn

  • 中图分类号: R617, R329.4

Efficacy analysis of T lymphocyte polyclonal antibody in renal transplantation from donor kidney of organ donation after citizen's death

More Information
  • 摘要:   目的  比较不同T细胞多克隆抗体在公民逝世后器官捐献供肾肾移植中的临床疗效。  方法  回顾性分析行公民逝世后器官捐献供肾肾移植的691例供、受者的临床资料。根据用于诱导的T细胞多克隆抗体不同, 将受者分为兔抗人T细胞免疫球蛋白(rALG)组(414例)和兔抗人胸腺细胞免疫球蛋白(rATG)组(277例)。收集两组受者移植肾功能恢复情况, 包括受者肾移植术后移植肾功能延迟恢复(DGF)和急性排斥反应(AR)的发生情况、术后血清肌酐水平的变化; 收集肾移植术后受者和移植肾1年的生存率; 统计术后1年内不良反应的发生率; 按供者DGF风险评分分为5组, 统计各组受者的rALG和rATG的使用比例。  结果  rALG组和rATG组受者DGF发生率分别为14.5%(60/414)、11.9%(33/277), rALG组、rATG组受者DGF持续时间分别为(7±4)d、(12±7)d, 两组间差异无统计学意义(P > 0.05)。rALG组AR发生率为7.5%(31/414), 明显高于rATG组的4.0%(11/277)(P < 0.05)。两组受者肾移植术后6个月内血清肌酐均呈逐渐下降的趋势。供者DGF风险评分为0~15分的供肾肾移植中, rALG的使用比例显著高于rATG; 而供者DGF风险评分 > 16分的供肾肾移植中, rATG使用的比例显著高于rALG(P < 0.05)。rALG组和rATG组受者、移植肾1年存活率分别为99.8%和99.6%、98.1%和98.2%, 两组间差异均无统计学意义(均为P > 0.05)。rATG组受者急性肺水肿和白细胞减少的发生率显著高于rALG组(均为P < 0.05)。  结论  rALG和rATG均能有效降低公民逝世后器官捐献供肾肾移植术后DGF及AR发生率, 获得良好的临床效果, rATG诱导的肾移植受者白细胞减少和急性肺水肿发生率高于rALG。

     

  • 图  1  两组肾移植受者血清肌酐水平

    注:A图为DGF受者术后血清肌酐变化; B图为非DGF受者术后血清肌酐变化, 与rATG组比较, aP < 0.05。

    Figure  1.  Serum creatinine levels of renal transplant recipients in the two groups

    图  2  按供者DGF风险评分分组的肾移植受者的2种T细胞多克隆抗体的使用比例

    Figure  2.  The proportion of two T cell polyclonal antibodies used in renal transplant recipients grouped by donor DGF risk score

    表  1  两组肾移植受者的并发症发生情况

    Table  1.   Occurrence of complications of renal transplant recipients in two groups [n(%)]

    组别 n 感染 白细胞减少 血小板减少 急性肺水肿
    rATG组 277 30
    (10.8)
    37
    (13.4)
    45
    (16.2)
    7
    (2.5)
    rALG组 414 39
    (9.4)
    21
    (5.1)
    42
    (10.1)
    2
    (0.5)
    P 0.541 0.046 0.057 0.013
    下载: 导出CSV
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  • 收稿日期:  2020-06-17
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2020-09-15

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