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山东大学学报(医学版)

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流式细胞仪交叉配型对移植肾1年存活率的影响

文蓉珠1,Paul Keown2,柳刚1,吕学爱1,Vivian Wu2,宋春燕3,关广聚1   

  1. 1. 山东大学第二医院肾内科, 山东 济南 250033; 2. 加拿大温哥华医院免疫科;3.胜利油田物探医院, 山东 东营 257000
  • 收稿日期:2006-03-18 修回日期:1900-01-01 发布日期:2006-06-25
  • 通讯作者: 文蓉珠

Predictive value of flow cytometry crossmatch to oneyear graft loss following kidney transplantation

WEN Rong-zhu, Paul Keown,Vivian Wu, LIU Gang, L XUE-ai,SONG Chun-yan,GUAN Guang-ju   

  1. 1. Department of Nephrology, Second Hospital of Shandong University, Jinan 250033, Shandong, China;2. Department of Pathology and Laboratory Medicine, Vancouver Hospital, 320575 West 8th Avenue, Vancouver,BC. V5Z 1C6 Canada;
  • Received:2006-03-18 Revised:1900-01-01 Published:2006-06-25
  • Contact: WEN Rong-zhu

摘要: 目的:探讨流式细胞仪交叉配型(flow cytometry crossmatch, FCXM)对移植肾一年存活率的影响。方法:应用χ2检验比较FCXM阳性与阴性组间1年移植肾死亡有无差异。以“移植后1年肾脏的存活状况(是/否)”为应变量,以移植后早期排斥反应(移植后1月内发生)、血管性排斥反应、移植肾功能延迟(移植后1周内需做血液透析)、FCXM、群体抗原反应抗体(PRA)、 HLAA,B配型、HLADR配型、供者类型(尸肾/活体供肾)、既往移植次数、免疫抑制药物的使用、血清巨细胞病毒状态、冷缺血时间、供者和受者年龄等可疑影响因素为自变量建立Logistic回归模型,探讨流式细胞仪交叉配型对移植肾1年存活有无影响。结果:258例患者平均随访时间为25个月(12~60个月),期间30例移植肾死亡,其中23例发生在移植后1年内。 χ2检验显示,FCXM阳性与阴性组间1年移植肾死亡无统计学差异(P=0.157?0)。 Logistic 回归显示,对移植肾1年死亡有影响的因素包括移植肾功能延迟(OR=8.00, P=0.001?4),供者类型为尸肾(OR=9.30, P=0.001?7)和血管排斥反应(OR=5.05, P=0.021?9)。FCXM的结果不会影响移植肾一年存活率(OR=1.60, P=0.534?6)。结论: FCXM对移植肾1年后存活尚无肯定的影响。

Abstract: Objective: Flow cytometry crossmatch (FCXM) has been extensively used in kidney transplantation, but there is no agreement regarding its predictive value for oneyear graft loss following kidney transplantation. The aim of the study was to explore the relationship between FCXM and oneyear graft loss following kidney backward stepwise method. Results: Graft loss occurred in 30 subjects during the followup, and 23 graft losses happened in the first year following kidney transplantation. χ2 test showed that there was no statistical difference regarding oneyear graft loss between FCXM positive and negative groups. Logistic regression showed that the significant predictors for oneyear graft loss were delayed graft function (OR=8.00, P=0.001?4), cadaver donor (OR=9.30, P=0.001?7) and vascular rejection (OR=5.05, P=0.021?9). FCXM was not a significant predictor with an odds ratio of 1.60 (P=0.534?6). Conclusion: FCXM has no predictive value for oneyear graft loss following kidney transplantation.transplantation. Methods: χ2 test was used to compare oneyear graft loss rate between FCXM positive and negative groups. Logistic model was built to measure the association between flow cytometry crossmatch and oneyear graft loss, and model variables included early acute rejection, vascular rejection, delayed graft function, positive FCXM, panel reactive antibody, HLAA, B mismatch number, HLADR mismatch number, donor resource, transplantation history, cold ischemic time, donor and recipient age and immunosuppression medication. The final model was determined by th

Key words: Kidney transplantation, Crossmatch, Regression analysis

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