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目的探讨群体反应性抗体 (PRA)配型新技术对肾移植近远期的效果。方法 85 4例患者肾移植前运用PRA新技术进行组织配型 ,并行血浆置换 ,未采用PRA组织配型的 42 3例作为对照 ,观察肾移植术后免疫指标变化、近期 (AR)发生率以及对长期存活的影响。结果未采用PRA组织配型组发生超急性排斥反应 (HR) 9例 (2 1% )、急性排斥反应 198例 (47% ) ;1年人/肾存活率 86 7% /76 3%、3年人 /肾存活率 72 5 % /6 7 9%、5年人 /肾存活率 6 9 5 % /4 9 3%。采用PRA配型新技术共 85 4例 ,肾移植术后未发生超急性排斥反应 ,发生急性排斥反应 16 2例 (19 0 % ) ,1年人肾存活率达 97 3% /95 0 %、3年人肾存活率 92 0 % /84 2 %、5年人 /肾存活率 87 0 % /81 6 %。结论PRA阴性配型可杜绝超急性排斥反应发生 ,降低急性排斥反应发生率 ,提高人 /肾长期存活率。
Objective To investigate the short-term and long-term effects of the new combination therapy of group reactive antibody (PRA) on kidney transplantation. Methods Eight hundred and four patients undergoing kidney transplantation were enrolled in this study. 423 patients without PRA were enrolled in this study. The changes of immune index, the incidence of immediate (AR) Impact on long-term survival. Results 9 cases (21%) had acute hyperacute rejection (HR) and 198 cases (47%) had acute rejection without using PRA tissue matching group. One year survival rate was 86.7% / 76.3% The survival rate of human / kidney was 72.5% / 67.9%, and the survival rate of 5 years was 69.5% / 49.3%. A total of 854 new patients were treated with PRA matching technique. No hyperacute rejection occurred after renal transplantation. 162 cases (190%) developed acute rejection, 97.3% / 95% survival rate after one year, The 3-year human kidney survival rate was 92 0% / 84 2%, and the 5-year human / kidney survival rate was 87 0% / 81 6%. Conclusions PRA-negative pattern can prevent the occurrence of hyperacute rejection, reduce the incidence of acute rejection and improve the long-term survival rate of human / kidney.