Post Transplant Development Of HLA Antibodies And MICA Antibodies On Renal Allograft Function Of Injury

Objects1 To study the injury of post transplant development of HLA antibodies and MICA antibodies on renal allograft function.2 Through regularly detecting HLA antibodies and MICA antibodies after renal transplantation and collecting routine rechecked data such as Serum creatinine (SCr),urine protein quantitation /24 h,the incidence of aderse immune events and so on, We tried to approach the dynamic influence of HLA antibodies and MICA antibodies on renal allgraft funcation and its performance .MethodologyUsing retrospective analysis, at the first,third,sixth,ninth and twelfth fourth month post-transplantation and adverse immune events episode, post transplant sera of 96 renal transplantation patients who have no preexisting antibody were tested by Luminex flow cytometry for HLA antibodies and MICA antibodies . These patients were followed-up 1 year after renal transplantation and collected information including blood routine,urine routine,urine protein quantitation /24 h,liver and renal function,ciclosporin A/tacrolinmus concentration. According to follow-up data patients were divided into HLA antibodies positive group, MICA antibodies positive group, both antibodies negative group, compared the incidence of adverse immune events and the dynamic change of renal funcation. Results1. Among 96 patients ,23 cases had HLA antibodies( class I :2 cases ;class II:17 cases ; class I and class II :4 cases ),13 cases had MICA antibodies.2. A higher serum creatinine level in 1th and 3th month after transplantation was evidenced in the HLA antibodies positive patients with acute rejection(AR) episodes than in those who had AR but did not produce antibodies. In MICA antibodies positive patients with AR, the serum creatinine level in the 3th month after transplantation was higher than the patients who had AR but without antibodies . In HLA antibodies positive patients without AR, the serum creatinine level in the 9th and 12th month after transplantation was higher than the patients who had neither antibodies nor AR.3. Urine protein quantitation in both HLA antibodies positive group and MICA antibodies positive group in the 3rd,6th,9th and 12th month after transplantation exceeded 150mg and increased along with time.4. The incidence of acute rejection in the HLA antibodies positive group is higher than the group without antibodies. There was no statistical significance in the AR episodes between the MICA antibodies positive group and the groupe without antibodies.ConclusionPost transplant development of HLA antibodies and MICA antibodies can cause renal allograft function of injury. HLA antibodies to early renal transplant damage is associated with the rising serum creatinine,urine protein quantitation and AR episode.MICA antibodies may result in an increase in urine protein quantitation for the kidney recipient and mediate chronic renal allograft injury accordingly. The HLA antibodies and MICA antibodies should be monitored after renal transplantation and effective therapeutic measures should be taken to the patients with antibodies.