Association of pre-transplant serum level of anti-endothelial cell antibody with acute rejection in kidney transplant recipients
10.3760/cma.j.issn.1001-7097.2009.12.003
- VernacularTitle:肾移植受者术前血清抗血管内皮细胞抗体与急性排斥反应的关系
- Author:
Fei HAN
;
Rong LV
;
Juan JIN
;
Jianyong WU
;
Ying CHEN
;
Huiping WANG
;
Jianghua CHEN
- Publication Type:Journal Article
- Keywords:
Kidney transplantation;
Endothelial cells;
Antibody;
Acute rejection
- From:
Chinese Journal of Nephrology
2009;25(12):896-900
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the pre-transplant serum level of anti-endothelial cell antibody(AECA)in kidney allograft recipients and its impact on the episode of acute rejection (AR) within 6 months after transplantation. Methods A total of 495 kidney allograft recipients with pre-transplant serum between December 1998 and August 2003 in our center and 40 healthy controls(negative controls)were enrolled in the study.Clinical data including AR within 6 months after transplantation were analyzed retrospectively.The serum AECA level was measured by cyto-ELISA using EA.hy926 cells as substrate,which was shown as the ratio of P (patient)/N (negative control)=(A_(petient)-A_(blank contrnal)/(A_(negative contral)-A_(blank contral).AECA was considered positive when P/N value Was greater than the average A_(negative control)value plus two times the standard deviation.Results Positive rate of AECA was 18.8%(93/495).AECA level in hemodialysis patients who had been on hemodialysis more than 12 months was 1.43±0.37,greater than those less than 12 months(1.27± 0.32,P=0.013)and those of non-dialyzed patients(1.31±0.32,P=0.029).Correlation coeffieient between AECA level and hemodialysis duration was 0.218 (P=0.018).AR incidence in AECA positive recipients was 38.7%,greater than that in AECA negative recipients (23.4%,P=0.002). Incidence of acute T cell-mediated rejection and acute antibody-mediated rejction increased significantly (P=0.035,P=0.002 respectively).Multifactor logistic regression analysis indicated that AECA positive,PRA greater than 1 0%and high CDC level were risk factors of AR with odds ratio of 2.056,1.751 and 1.764 respectively(P=0.004,0.029,0.050). Conclusions The AECA positive in pre-transplant serum indicates the elevated risk of acute allograft rejection.The AECA level increases with prolonged hemodialysis duration.
