Characterization of Minor HA-1 in Patients Who Underwent Living Donor Kidney Transplantation

Abstract

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Keywords

• Transplantation; minor histocompatibility antigens; rejection

Canlı Donörden Böbrek Transplantasyonu Yapılan Hastalarda Minör HA-1 Dağılımı

Öz

Amaç: Son dönem böbrek yetersizliği (SDBY) olan hastalar için hayat standartlarını arttıran bir tedavi yöntemi olan böbrek naklinde HLA uyumunun önemi bilinen bir gerçektir. Alıcı ve verici arasındaki İnsan Lökosit Antijenleri (Human Leukocyte Antigens, HLA) uyumunun, allojenik böbrek transplantasyonu sonrası graft sağkalımı üzerine önemli bir etkisi vardır. Ancak HLA identik kardeşler arası yapılan transplantlar da graft kaybı ile sonlanabilmektedir. Minör histokompatibilite antijenleri (mHag) HA-1, 19. kromozom üzerindeki diallelik genlerce kodlanan, 9 aminoasitlik düşük polimorfizm gösteren immünojenik bir peptiddir. Minör histokompatibilite antijenleri, HLA uyumlu solid organ transplantasyonlarının graft rejeksiyonu için potansiyel bir risk faktörüdür. Yaptığımız bu çalışmada böbrek transplantasyonunda mHA-1 uyumu veya uyumsuzluğunun, transplant sonrası graft sağkalımı ile ilişkisini araştırmayı amaçladık.Hastalar ve Yöntemler: Son dönem böbrek yetersizliği tanısı konmuş 59 hasta ile onların akraba vericileri çalışmaya alındı. Minör HA-1 genotipleri ise PCR-SSP yöntemiyle ticari kitler kullanılarak yapıldı.Bulgular: 59 hastada HH, RR, HR genotiplerinin sıklıkları sırası ile %17, %25 ve %58 idi. Rejeksiyon/rejeksiyon atağı saptanması ile mHA-1 uyumu açısından anlamlı bir fark saptanmadı (p=0.73, Or=1.44, güven aralığı=0.36-5.74; Fischer’s Exact Test). Kronik Allograft Nefropatisi (KAN) gelişimi ile mHA-1 uyumu açısından anlamlı bir fark saptanmadı (p=0.61, Or=2.89, güven aralığı=0.28-29.57; Fischer’s Exact Test).Sonuç: Yaptığımız çalışmada canlı donörden böbrek nakillerinde rejeksiyon ile HA-1 uyumsuzluğu arasında anlamlı bir fark saptayamadık

Anahtar Kelimeler

• Transplantasyon, minör histokompatibilite antijenleri, rejeksiyon

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