Kaneku Hugo
UCLA Department of Surgery, Liver Transplant Services, Los Angeles, California, USA.
Clin Transpl. 2010:283-306.
This chapter summarizes some of the recent findings published on the role in organ transplantation of HLA antibodies, and--more important--donor-specific HLA antibodies. The negative impact of both, preformed and de novo DSA is now better recognized in recipients of kidney, heart, lung, liver, pancreas, islet cells and bone marrow transplants. An appropriate design of a schedule to monitor HLA antibodies may identify patients at higher risk for immunological events earlier and allow interventions to avoid later graft loss. The value of strategies like preemptive treatment of antibodies and the use of new agents like bortezomib and eculizumab are of interest and need further investigation.
本章总结了近期发表的一些关于人类白细胞抗原（HLA）抗体，更重要的是供体特异性HLA抗体在器官移植中作用的研究结果。预先形成的和新发的供体特异性抗体（DSA）对肾、心、肺、肝、胰腺、胰岛细胞和骨髓移植受者的负面影响，如今已得到更充分的认识。合理设计监测HLA抗体的方案，可能更早地识别出发生免疫事件风险较高的患者，并采取干预措施以避免后期移植物丢失。抗体的抢先治疗以及使用硼替佐米和依库珠单抗等新型药物等策略的价值值得关注，且需要进一步研究。
