Detection And Clinical Significance Of Post-transplant MICA Antibodies In Renal Allografts

【Objective】The aim of our study is to explore the impact of post-transplant MICA antibodies on renal allograft function . MICA antibodies are monitored before and after transplantation in kidney recipients , the level of MICA antibodies can diagnose renal rejection . we want to know whether it's a factor that can predict the prognoses of renal transplantation and how to treat it .【Methods】Our retrospective analyses included 50 kidney allograft recipients who were transplanted and clinically managed in our center between 1994.1 and 2007.3 and 7 recipients who were followed by pretransplantation,1st month,3rd month,6th month,1st year between 2006.10 and 2008.3. We collected 57 among them (46 men and 11women, mean age 42) , Each patient had one serum sample taken. MICA antibodies and HLA antibodies were detected by using Flow PRATM beads , Simultaneously, their serum creatinine levels were tested. Then according to clinical data ,the impact of MICA antibodies on renal allograft function was assessed.【Results】(1)Among 57 patients, 8 cases (14.0%) had MICA allele-specific antibodies, where 5 cases had MICA antibodies without HLA antibodies , 49(86.0%) cases were without MICA antibodies(.2)There were no obvious differences between patients with and without MICA antibodies in the aspects of sex, blood transfusion history, CDC, cold ischemia time (P>0.05),except for age(p=0.008) ,the average ages were 32.5±7.95 and 43.0±10.38,respectively.(3)The levels of serum creatinine and the percentage with abnormal serum creatinine in patients with MICA antibodies and without HLA antibodies were both higher than those without MICA and HLA antibodies (P<0.05),the average levels of serum creatinine were 117±12.30umol/L and 89.41±28.95 umol/L,respectively. (4)The patients with MICA19 antibodies were 5 cases(41.7%) , MICA027 antibodies were 3 cases(25%).most of antibodes were more than 6 scores .(5)Immunosuppressants have some influence on the tite of MICA antibodies .The type of MICA allele were not increasing ,the scores of MICA antibodies were always changing .【Conclusions】1.MICA antibodies are mainly detected by Flow PRATM beads, which are high sensitivity and specificity.2.The presence of MICA antibodies are clinically relevant with the chronic decline of renal allograft function. MICA antibodies are a useful adjunct marker molecule to diagnose of renal rejection episode with humoral component .MICA antibodies play a role in renal rejection.3.If the patients have MICA antibodies before renal transplantion, t hey were detected the MICA allele after renal transplantation. we make measure reduce it and raise survival of renal transplantation.4.Immunosuppressant can reduce the tite of MICA antibodies , but they can't effect the target of MICA alleles, new and specific immunosuppressants conduce to raise survival of renal allografts.