Stegall Mark D
Von Liebig Transplant Center, Department of Surgery, Division of Transplant Surgery Mayo Clinic, Rochester, MN, USA.
Clin Transpl. 2010:307-15.
Our understanding of the role of DSA in both early and late renal allograft injury has advanced significantly over the past decade. Novel protocols have been developed that have led to improved outcomes both in overcoming a positive crossmatch and in the treatment of early AMR. Early experience with bortezomib and eculizumab are encouraging and suggest the possibility of validation in controlled clinical trials. While alloantibody remains an extremely difficult clinical problem and it is unclear if overcoming early hurdles will only be followed by another major hurdle of chronic antibody mediated injury. However, it is clear that significant advances have occurred and if future studies can be designed appropriately, then our ability to control alloantibody in sensitized patients will continue to improve.
在过去十年中，我们对DSA在早期和晚期肾移植损伤中作用的理解有了显著进展。已经开发出了新的方案，在克服阳性交叉配型以及治疗早期急性抗体介导的排斥反应（AMR）方面都取得了更好的结果。硼替佐米和依库珠单抗的早期经验令人鼓舞，并表明有可能在对照临床试验中得到验证。虽然同种抗体仍然是一个极其棘手的临床问题，而且尚不清楚克服早期障碍后是否只会面临慢性抗体介导损伤这另一个主要障碍。然而，很明显已经取得了重大进展，如果未来的研究能够得到恰当设计，那么我们控制致敏患者同种抗体的能力将继续提高。
