Study On CREGs Zygosity Principle Applied In Kidney Transplantation

At present kidney transplantation had become the preferred way to cure renal failure. long-term exceed acute rejection and accelerated rejection is the most important cause on earlier period of transplantation abortive . at present theory presume.the immune reaction which caused by graft antigen is the most important material cause the graft rejection .the MHC antigen is the most important cause which pose the graft rejection and long-term graft functional incapacitation . encipher human MHC (HLA)antigenic gene . located AT number 6 the short arm of a chromosome , among the total HLA-A,HLA-B and HLA-DR,HLA-DQ genes polymorphism is multiplicity.which antigen production has the most close relationship.with graft rejective reaction. Therefore favourable tissue matching is the most important condition which caused kidney transplant patient long-term surviving and graft; functional recovery.But on account of HLA system have altitude polymorphism ,at present A antigenic specificity arrive 86, B antigenic specificity arrive 86,DR antigenic specificity arrive 197,so nearly 500 antigenic specificity Arrange combination,,which make fully difficult to find antigen no mismatch from unrelated donor . clinical practice application suffered many confine . otherwise kidney Deficit bue the wait donee more and more large.The Strict HLA zygosity , even though in more wide-bound to blend kidney , still pose some quant kidney abandon. kidney transplant donee who wait for match kidney process still go through very long andsuffering Dialysis ,and spend enormous. on account of patient whose dialyzed survival rate is low.made a good many of patient death before they wait for the suitable kidney . clinically need a both secure and achieve match HLA zygosity method.In the 1993 Maruya according to a large of clinical data then propose the concept that acceptable antigenic mismatching and immunogenic antigenic mismatching . Immunologic investigation confirm:when antigen enter vivo, through antigen presenting cell handle,the donee cell who really recognition was 8～11amino acids peptide fragment..the immunoreactive nucleus was"(TCR)+ MHC+8～11 amino acids peptide fragment"constit.Three diamensions molecule Complex, not a single one can be omitted, recent; years the X diffraction analysis a couple to MHC molecule crystal structure display.in the MHC molecular Cuff position exist 9～26 amino acids peptide fragment..CD4 aid masculine TCR noetic is this contain self MHCⅡand not-self antigen peptide fragment compound .so suppose that donee noetic antigen determinant is definitive by key point regional amino acid residue ,when both the two antigen in the same cross-reactive group.the immune reaction is hyporesponsiveness or did not respond, respecting HLA polymorphism and amino acid residue The position in histocompatibility. Process clinical organ transplant exploratory development, Thompson investigate consider belong to serology same cross-reactive group,that the antigen misalliance can not induce rejection increase.and the HLA match rate between donor-recipient predominance elevate. Therefore CREG provide one satisfactoryzygosity method to clinical kidney transplant .who can evidence amino-acid residue mode elevate tissue matching rate.and can be extensively use in Clinical requirement.Mass of investigation and clinical data certificate that on the basis of HLA–CREGs zygosity will elevate donor-recipient matching rate ,and depress antibody sensitize rate ,then we can more extensively to choose donor-recipient in transplantation . otherwise a great quantity of finding confirm that in the acute rejection incidence rate the matching DR antigenic is more important then matching B antigenic,and matching A antigenic is no effect in acute rejection . the acute rejection rate will reduce when DR antigen matching satisfactory ,therefore the acute rejection rate will reduce when HLA-Ⅱdonor-recipient zygosity satisfactory,also profit to graft functional recover . at the same time can depress graft donee sensitization ,and profit to graft long-term surviving, HLA– DR antigenIs more important then HLA - A,B antigen.This text concerning our transplantation center January to December 2005 operating 173 renal homotransplantations,then according to state-maintained organ typing center to institute HLA cross-reactive group zygosity principle progress donor-recipient zygosity . combine patient ann take place acute rejection rate statistics progress retrospective analysis, result:HLA-A zygosity 0MM is 6.48%,2MM is39.67%,ResM-A zygosity 0MM is 39.3%,2MM drop to 4.04%; HLA-B zygosity 0MM is 1.98%,2MM is 65.27%, ResM-B AG zygosity 0MM is 17.3%,2MM drop to 29.25%;HLA-DR AG zygosity 0MM is 3.95%,2MM is 58.38%,andResM-DR zygosity 0MM is 14.35%,2MM drop to 36.9%.HLA-DQ AG zygosity 0MM is 4.81%,2MMis 51.46%,ResM-DR zygosity 0MM is31.21%,2MM drop to 12.14%。conclusion:contrast HLA zygosity principle,CREGs zygosity principle each site AG match each other rate increase,contrast HLA zygosity principle,CREGs zygosity principle each site AG acute rejection incidence rate not statistically significant, CREGs zygosity principle surpass orthodox HLA zygosity.