ABO 血型不合：成功肾移植的障碍在减少？

ABO blood group incompatibility: a diminishing barrier to successful kidney transplantation?

机构信息

Comprehensive Transplant Center, Transplant Immunotherapy Program, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.

出版信息

Expert Rev Clin Immunol. 2010 Nov;6(6):893-900. doi: 10.1586/eci.10.78.

DOI:10.1586/eci.10.78

PMID:20979554

Abstract

Blood type-incompatible transplantation has gained wide acceptance over the last decade. This is largely the result of B-cell-directed therapies aimed at modulating anti-blood group antibodies, which were the cause of the poor outcomes originally seen. Now rituximab (anti-CD20 and anti-B cell) has largely replaced splenectomy in preconditioning protocols, allowing for the wider implementation of ABO-incompatible transplants. Plasma exchange followed by intravenous immunoglobulin is also critical for the success of ABO-incompatible transplants. In this article, we describe the important contributions immunomodulatory drugs and antibody reduction therapies have made in achieving excellent outcomes in what was once an impenetrable barrier to transplantation.

摘要

在过去的十年中，血型不合移植已被广泛接受。这主要是由于旨在调节抗血型抗体的 B 细胞靶向治疗的结果，这些抗体最初导致了不良结果。现在利妥昔单抗（抗 CD20 和抗 B 细胞）在预处理方案中已基本取代脾切除术，从而可以更广泛地实施 ABO 不合移植。血浆置换加静脉注射免疫球蛋白对于 ABO 不合移植的成功也至关重要。在本文中，我们描述了免疫调节药物和抗体减少疗法在克服曾经是移植难以逾越的障碍方面取得的出色成果所做出的重要贡献。