| Renal transplantation is a very effective way to treat uraemia. Nowadays renal allografts mainly come from cadavers and the main obstacle of renal transplantation is rejection. With the development of matching technology and immunosuppressant, the incidence of acute rejection has decreased greatly, but it is still at a rate of 30~50% within one month after cadaveric renal transplantation. Acute rejection remains the main factor of allograft's dysfunction at early stage, which affects the long-term survival of allograft. If it can be diagnosed and treated early, the cure rate will be raised and reversion rate will be over 90%. Thus, early diagnosing or predicting acute rejection is very important for improving allograft's survival rate. But there is not a simple,non-invasive,sensitive and specific immune exam way which is used in clinical diagnosis and prediction of acute rejection at early stage at present, especially in the prediction .Adhesion molecule(AM) is a general designation of many molecules which mediate intercellular or extracellular matrixes' contact and combination and is an important immunocyte membranous molecule. It is generally acknowledged that AM plays an important role in renal graft rejection, and the functions of Leukocyte function-associated antigen-1(LFA-1) and Intercellular adhesion molecule-1(ICAM-1) are especially important. Many researches show that LFA-1 and ICAM-1 are very important in acute renal graft rejection. Their combination not only promote immune system to attack kidney graft, but participate in immune attack directly.Objective:1.To study the correlation between kidney transplant recipient's peripheral blood lymphocytes LFA-1,ICAM-1 gene expression level with donor-specific antigen, third-party antigen and without antigen stimulation before and after renal transplantation and acute rejection.2.To study the effect of kidney transplant recipient's peripheral blood lymphocytes LFA-1,ICAM-1 gene expression level with donor-specific antigen, third-party antigen and without antigen stimulation before and after renal transplantation on the prediction of acuterejection.Methods:1.Donor's spleens were gotten and made into spleen cells suspension. Recipient's peripheral vein blood was drawn pretransplant and at the fourth day of posttransplant and lymphocytes were separated from it. Meanwhile we followed to investigate the incidence of acute rejection within one month after renal transplantation.2.In the mixed lymphocyte culture, donor and third-party's spleen cells were stimulation cells, recipient's lymphocytes were reaction cells. The stimulation index(SI) of donor and third-party's spleen cells stimulating recipient's lymphocytes proliferation was determined by MTT method. The recipient's lymphocytes LFA-1,ICAM-1 gene expression level with donor,third-party spleen stimulation and without stimulation determined by half-qualify RT-PCR method. Results:1.Thirty five patients in study group, who got donor's spleens and peripheral blood lymphocytes, were determined. 10 of 35 patients suffered from acute rejection within one month after renal transplantation. The incidence of acute rejection was 28.67%.2.There were no significant differences of SI of donor and third-party spleen cells' stimulating recipient's lymphocytes proliferation between the patients with and without acute rejection pretransplant and at fourth day of posttransplant(P>0.05). The drop value of SI of donor's spleen cells' stimulating normal group lymphocytes proliferation was much higher than its stimulating rejection group. There were significant differences between them(P<0.05). Whereas the drop value of SI of third-party's spleen cells stimulation had no significant differences between normal group and rejection group(P>0.05).3. Before transplant and at the fourth day of posttransplant, there were no significant differences of recipient's lymphocytes LFA-1,ICAM-1 gene expression level with third-party spleen cells stimulation and without stimulation between the patien... |
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