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肾移植后的致敏作用。

Sensitization after kidney transplantation.

作者信息

Akalin Enver, Pascual Manuel

机构信息

Renal Division and Recanati/Miller Transplantation Institute, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1104, New York, NY 10029, USA.

出版信息

Clin J Am Soc Nephrol. 2006 May;1(3):433-40. doi: 10.2215/CJN.01751105. Epub 2006 Jan 25.

Abstract

Kidney transplant recipients may develop de novo anti-HLA and non-HLA antibodies after transplantation. Although these antibodies may be donor-specific or non-donor-specific, their presence may increase the risk for acute and chronic rejection, thereby decreasing allograft survival. The introduction of more sensitive and specific methods to detect anti-HLA antibodies, such as Flow Specific Beads and FlowPRA, both before and after transplantation, will help to define immunologically high-risk kidney transplant recipients. Thus, posttransplantation monitoring of anti-HLA antibody production will allow the identification of kidney transplant recipients who might be at increased risk for late allograft failure. Moreover, knowledge of alloantibody status after transplantation may help to guide the appropriate use of immunomodulatory agents to downregulate anti-HLA antibody production.

摘要

肾移植受者在移植后可能会产生新的抗 HLA 和非 HLA 抗体。尽管这些抗体可能是供体特异性或非供体特异性的,但它们的存在可能会增加急性和慢性排斥反应的风险,从而降低移植肾的存活率。在移植前后引入更敏感和特异的方法来检测抗 HLA 抗体,如流式细胞术特异性微珠检测法(Flow Specific Beads)和群体反应性抗体检测法(FlowPRA),将有助于确定免疫高风险的肾移植受者。因此,移植后对抗 HLA 抗体产生情况进行监测,将有助于识别那些移植肾晚期失功风险可能增加的肾移植受者。此外,了解移植后的同种抗体状态可能有助于指导合理使用免疫调节药物来下调抗 HLA 抗体的产生。

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