外科LEE, PO-HUANGPO-HUANGLEE2008-12-162018-07-112008-12-162018-07-112002http://ntur.lib.ntu.edu.tw//handle/246246/91938Background. Recent studies show that almost all patients who have rejected a kidney transplant had human leukocyte antigen (HIA) antibodies. In this study, we sought to determine whether patients develop HIA antibodies before chronic rejection. Methods. For the past 8 years, 139 patients who had undergone kidney transplantation were systematically examined, using an enzyme-linked immunosorbent assay-based method, for the development of class-I and class-II HLA antibodies 3 months, 6 months, and yearly after transplantation. Chronic rejection was diagnosed by biopsy. Results. Among 29 patients with chronic rejection, 100% of the patients had HLA antibodies before rejection. Of these patients, 14 patients developed antibodies de novo. In contrast, among 110 patients with stable function, 27% of the patients developed HLA antibodies posttransplant (P<0.001). Conclusions. HLA antibodies were found in 29 consecutive cases of chronic rejection failures as much as one year before the loss of grafts. We conclude that HLA antibodies may be a prerequisite for chronic immunologic rejection.en-USjournal article