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中华移植杂志(电子版) ›› 2017, Vol. 11 ›› Issue (01) : 54 -58. doi: 10.3877/cma.j.issn.1674-3903.2017.01.013

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综述

C4d和供者特异性抗体检测在肾移植抗体介导排斥反应中的应用研究进展
侯鹏1, 季曙明2,()   
  1. 1. 211131 南京总医院疗养区
    2. 210002 南京总医院 全军肾脏病研究所 国家肾脏疾病临床医学研究中心
  • 收稿日期:2016-08-22 出版日期:2017-02-25
  • 通信作者: 季曙明
  • 基金资助:
    国家自然科学基金(81270834)

C4d and donor specific antibody in the application research of antibody-mediated rejection

Peng Hou1, Shuming Ji2,()   

  1. 1. Tangshan Convalescence Area, Nanjing General Hospital, Nanjing 211131, China
    2. National Clinical Research Center of Kidney Diseases, Nanjing General Hospital, Nanjing University School of Medicine, Nanjing 210002, China
  • Received:2016-08-22 Published:2017-02-25
  • Corresponding author: Shuming Ji
  • About author:
    Corresponding author: Ji Shuming, Email:
引用本文:

侯鹏, 季曙明. C4d和供者特异性抗体检测在肾移植抗体介导排斥反应中的应用研究进展[J/OL]. 中华移植杂志(电子版), 2017, 11(01): 54-58.

Peng Hou, Shuming Ji. C4d and donor specific antibody in the application research of antibody-mediated rejection[J/OL]. Chinese Journal of Transplantation(Electronic Edition), 2017, 11(01): 54-58.

抗体介导排斥反应(AMR)已经成为导致移植物丢失的主要原因。C4d在管周毛细血管(PTC)部位沉积是肾移植体液免疫活跃的标志,单纯C4d阳性不能确诊为AMR,当临床上出现循环供者特异性抗体(DSA)、病理特征和/或移植肾功能不全时必须考虑AMR。C4d和DSA检测阳性与移植物存活率下降密切相关,特别是在检测时就出现移植物功能不全者。本文主要围绕C4d和DSA检测在肾移植AMR中的应用研究作一综述。

Antibody-mediated rejection (AMR) has become a main reason in graft loss. The detection of C4d deposition in peritubular capillarie (PTC) is a valuable marker of humoral activity in the renal allograft. C4d positivity alone is nondiagnostic for antibody-mediated rejection. Presence of circulating HLA donor-specific antibody (DSA), histologic features, and/or graft dysfunction must be considered in the context of the clinical scenario. C4d positivity and DSA, particularly complement fixing, are associated with decreased allograft survival, particularly when detected in the setting of graft dysfunction.

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