Immunogenetics Laboratory, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Immunol Res. 2010 Jul;47(1-3):232-9. doi: 10.1007/s12026-009-8154-1.
Advances in immunogenetics and histocompatibility have facilitated the clinical transplantation of solid organs and tissues. Improved definition of HLA antigens, alleles, and haplotypes has clarified the diversity of the HLA system among different racial/ethnic populations. Knowledge of allele and haplotypes frequencies derived from these studies can be applied to the estimates of transplant compatibility and the likelihood finding suitable donors. Humoral sensitization that has been a major barrier to transplantation is being successfully treated with desensitization and paired donor exchanges. Sensitive solid phase immunoassays for HLA-specific antibodies permit analyses that guide both desensitization and donor exchanges through antibody monitoring, virtual crossmatches, and detection of cryptic sensitization. Ongoing studies are investigating the mechanisms underlying the down-regulation of donor HLA-specific antibodies.
免疫遗传学和组织相容性的进步促进了实体器官和组织的临床移植。对 HLA 抗原、等位基因和单倍型的更好定义，阐明了不同种族/民族人群中 HLA 系统的多样性。这些研究中获得的等位基因和单倍型频率的知识可用于估计移植相容性和寻找合适供体的可能性。体液致敏一直是移植的主要障碍，但通过脱敏和配对供体交换已成功治疗。用于 HLA 特异性抗体的敏感固相免疫测定法允许通过抗体监测、虚拟交叉配型和隐匿性致敏检测来指导脱敏和供体交换的分析。正在进行的研究正在探讨下调供体 HLA 特异性抗体的机制。
