一种新的监测肾脏排斥反应的可见方法：同源供体源性前哨皮肤。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-05-09 DOI:10.1016/j.transproceed.2025.03.027

Xiangke Rong , Kai Wang , Jiezhang Tang , Jizhong Yang , Huilong Wang , Kepu Liu , Zhibin Li , Jing Li , Geng Zhang , Chenggang Yi

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引用次数: 0

摘要

背景：面部移植患者的排斥反应总是伴随着皮肤外观的变化，可以通过观察皮肤来监测。肾移植术后急性排斥反应（Acute rejection， AR）对移植肾的功能影响较大，监测难度较大。在这项研究中，同一供体的皮肤被用作监测肾移植排斥反应的哨兵。方法：取供肾者3 cm × 5 cm皮肤，与肾移植同时移植给受者，作为监测AR的前哨皮肤。术后通过观察前哨皮肤（SS）外观变化监测肾排斥反应。通过比较前哨皮肤移植组的12例患者和单独肾移植组的20例患者的肾功能，还评估了该手术的安全性。结果：SS移植患者与单纯肾移植患者术后采用相同的免疫抑制方案。两组间肌酐、尿素氮比较差异无统计学意义（P < 0.05），尿蛋白在2周、1、2个月比较差异有统计学意义（P < 0.05），试验组较低，3个月比较差异无统计学意义。另外，1例患者SS改变提示排斥反应，而此时肌酐正常，随后SS和肾活检正常，提示排斥反应程度不同。结论：SS联合同步肾移植是一种安全可行的手术方式。特别是，SS有望监测排斥反应和亚临床排斥反应。

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A Novel Visible Method for Monitoring Kidney Rejection: Homologous Donor-Derived Sentinel Skin

Backgrounds

Rejection in facial transplant patients is always accompanied by changes in skin appearance and can be monitored by observation of the skin. Acute rejection (AR) after kidney transplantation has a significant impact on the function of the transplanted kidney, which is relatively difficult to monitor. In this study, the skin of the same donor was used as a sentinel for monitoring the rejection of kidney transplantation.

Methods

A 3 cm × 5 cm skin was procured from the kidney donor and was grafted to the recipient at the same time as the kidney transplantation, to serve as a sentinel for monitoring AR. Postoperatively, kidney rejection was monitored by observing changes in the appearance of the sentinel skin (SS). The safety of this procedure was also evaluated by comparing the renal function in 12 patients in the sentinel skin graft group and 20 patients with kidney transplantation alone.

Results

The same immunosuppressive regimen was used postoperatively in patients with SS transplantation and those with kidney transplantation merely. There was also no statistical difference in creatinine and urea nitrogen between the 2 groups (P > .05), but a difference in urine protein (UP) (P < .05) in 2 weeks, 1and 2 months, which was lower in the test group, and no difference in 3 months. In addition, 1 patient had changes in the SS indicating rejection, while creatinine was normal at that time, which was followed by SS and kidney biopsy, suggesting both were of different grades of rejection.

Conclusions

SS combined with simultaneous kidney transplantation is a safe and feasible surgical approach. In particular, The SS holds promise for monitoring rejection and also sub-clinical rejection.

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.