中文摘要：

目的：研究供受者HLA-A、B、DRB1＆DQB1的相合率对移植肾近期效果的影响。方法：选择已完成供受者HLA基因分型，且术后持续随访＞13个月的358例初次肾移植移植受者，采集移植后首次发生急性排斥（AR）的时间、处理措施、AR恢复及肾功能情况，参照美国器官共享联合网络（UNOS）策略将供受者之间HLA-A、B、DRB1＆DQB1相合率0～8分组，共9个组，分析供受者之间HLA-A、B、DRB1＆DQB1的相合率及其与移植1年内AR和移植肾有功能生存的关联性。结果：358例移植肾供受者中，1年AR率为15.08％，分别比较HLA相合率0～8分组及以0～8分为节点的组合组间的AR率，其中1分组的AR率与3、4、5分组之间差异均具有统计学差异（P＜0.05），0～1分与2～8分组合组之间、0～2分与3～8分组合组之间以及0～3分与4～8分组合组之间差异均具有统计学差异（P＜0.05），其中0～2分与3～8分组合组相比差异性最大（2＝10.836）。1年人/肾存活率为95.81％，带功死亡率为1.40％（5例均为肺部感染），移植肾失功为2.80％；1年人/肾存活率从高到低依次为8分＝7分＝6分＞5分＞4分＞3分＞2分＞1分＞0分组，各组间差异均无统计学意义（P＞0.05）。结论：研究证实， HLA相合率对初次移植肾的近期效果具有显著影响，供受者间HLA 相合率越高，术后发生AR几率越低。但是HLA存在的高度多态性导致肾移植受者获得HLA-A、B、DRB1＆DQB1全相合供者的几率极低，因此，为了获得良好的肾移植近期效果，同时提高移植肾的长期存活率，初次肾移植受者应尽量选择供受者HLA相合率＞3分的供肾。

英文摘要：

Aim：To study the impact of HLA-A、B、DRB1＆DQB1 mismatch between recipient and do-nor on short-term effect of the renal transplant.Methods：Three hundred and fifty-eight cases of trans-plant recipients who accepted the initial renal transplant,PRA tested to be negative and had integrated＆nbsp;donor and recipient HLA genotyping data were Chose.Time of first occurrence of acute rejection（AR） after transplantation,method of processing,restoration and renal function of AR were collected.Accord-ing to the mismatch degree of HLA-A,B,DR ＆DQ between donor and recipient by the UNOS method, 358 recipients which divided into nine groups that from 0 to 8 points’ group.Then analyzed donor/recipient’s HLA-A,B,DR＆DQ mismatch rate and its association with acute rejection after transplanta-tion and the survival rate of 1 year after renal transplantation.Results：In 358 recipients,the acute re-jection incidence of 1 year was 23.1 3%.Compare the rate of AR in 0-8 points donor/recipient’s mis-match groups and 0-8 points combined groups,in which the 1 points group was significant differences to 3,4,5 points group respectively （P5 〉4 〉3 〉2 〉1 〉0 points group,and there were no statistically differences between each two groups （P〉0.05 ）.Conclusion：Our study con-firmed that HLA mismatch has a significant effect in short-term of renal transplant.The less HLA mis-match between donor/recipient,the lower the onset of postoperative AR.However,the presence of high-ly polymorphic in HLA gene leads to the chance of kidney transplant recipients receive a HLA-A,B, DRB1 ＆DQB1 full match kidney is very low.In order to get a good short-term effect of renal transplanta-tion,and improve the long-term graft survival,we believe that primary ranal transplant recipients should select a kidney that HLA-matches 〉3 points.