Abstract
Objective To explore the impact of anti-HLA and MICA antibodies on kidney graft func-tion by dynamic monitoring for two years. Methods The 135 patients to be subject to renal allngraft were de-teeted for specificity of anti-HLA and anti-MICA antibodies by flow PRATM beads. Among them 33 patients ac-cepted two-year dynamic monitoring. Also the IRA and MICA genotyping was done by using PR-SSOP,and do-nor specific antibody (DSA) and non-donor specific antibody (NDSA) were identified. Simultaneously,the ser-um ereatinine levels and clinical data were analyzed. Results The 46 patients were positive for antibody before transplantation in 135 patients (34. 1%). Among the 33 patients subject to dynamic monitoring,20 patients were negative for anti-HLA and anti-MICA antibodies before and after transplantation:7 patients had anti-MICA anti-body:2 patients were positive for both anti-HLA and anti-MICA antibodies:one patient was positive for anti-HLA antibody,and the remaining 3 patients developed de novo antibody at 6th month after transplantation (9.1%). Two patients negative for antibodies before transplantation had de novo antibodies: A33, A31 (one case), and DQ7,DRI7,DR18 (one case) at the 6th month after transplantation,then specific antibodies were DR12, and DRII at first to second years after transplantation. One patient had de novo MICA27 ,MICA02 antibody and HLA-B41 ,A32 antibedies one year after transplantation. There was significant difference in the Scr levels in 33 patients between positive and negative antibody groups (P ＜ 0. 05). The Scr levels were most significandy in-creased in anti-MICA antibody group (P ＜ 0.01). Conclusion Whether there is HLA and MICA antibodies before transpLantation,dynamic monitoring of the changes in HLA and MICA specific antibodies after transplan-tation is of great importance in predicting rejection and guiding clinieal therapy to prevent the occurrence and development of renal allograft function deficiency. Key words: Anti-HLA antibody; Anti-MICA antibody; Kidney transplantation
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