JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2017, Vol. 55 ›› Issue (7): 89-94.doi: 10.6040/j.issn.1671-7554.0.2016.1307

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Significance of lymphocytes and DSA monitoring for acute rejection diagnosis on the early stage of kidney transplantation

ZHENG Jin, ZHANG Jiangwei, WANG Xuzhen, KUANG Peidan, HE Xiaoli, XUE Wujun   

  1. Department of Kidney Transplant, Hospital of Nephrology, the First Affiliated Hospital of Xian Jiaotong University, Xian 710061, Shaanxi, China
  • Received:2016-10-14 Online:2017-07-10 Published:2017-07-10

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Abstract: Objective To analyze and monitor lymphocytes ratio, donor specificity antibodies(DSA)and non-donor specificity antibodies(NDSA)levels for acute rejection(AR)diagnosis on the early stage of kidney transplantation. To provide reliable basis for clinical prevention of rejection reaction, early diagnosis of rejection, formulate reasonable individualized immunosuppressive therapy and evaluate therapeutic effect. Methods A total of 454 patients who accepted kidney transplantation in our department from January 2014 to June 2016 were enrolled in this study. Recipients lymphocytes ratio, DSA, and NDSA were monitored with flow cytometry and Luminex. Data were analyzed statistically by SPSS17.0 software. Results Within 6 months after transplantation, 33 cases(7.3%)occurred AR(AR group)and 421 cases had stable allograft function(SF group). The CD4+T/CD8+T ratio(2.81±0.85 vs 1.39±0.94, t=7.336, P<0.001)and B cell percentage［(15.79±3.53)% vs(10.2±3.04)%, t=4.986, P<0.001］ were significantly higher in the AR group than the SF group. The HLA antibody medium fluorescent intensity(MFI)of the AR group was gradually increased one week after transplantation and had an obviously difference with that of the SF 山 东 大 学 学 报 (医 学 版)55卷7期 -郑瑾,等.肾移植术后早期淋巴细胞及DSA监测在诊断移植排斥反应中的意义 \=-group(P<0.05). The average value of MFI was 7 559±1 496 in the AR group and it was decreased statistically after treatment(5 023±996)(t=13.853, P<0.001). AR occurrence was 3.1%(11/357)and 14.5%(12/83)in DSA-/NDSA- and DSA-/NDSA+ recipients, respectively. For DSA+/NDSA+ recipients, AR occurrence was 71.4%(10/14)which was significantly higher than DSA-/NDSA- and DSA-/NDSA+ recipients(P<0.001). Conclusion Monitoring CD4+T/CD8+T ratio, B lymphocyte percentage and serum DSA/NDSA levels could assist in the diagnosis and the early warning of AR.

Key words: Lymphocyte, Non-donor specificity antibodies, Renal transplant, Immune state monitoring, Donor specificity antibodies

CLC Number: 

  • R392.4
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