Everly Matthew J
One Lambda, Inc., Canoga Park, California, USA.
Clin Transpl. 2010:317-22.
The evidence supporting HLA antibodies as a biomarker in transplant is substantial. It is becoming more clear that these patients represent a new phenotype of patient that is at the highest risk to rapidly progress to chronic damage. Therefore early detection of these high risk patients through serial screening is necessary. Additionally, once patients develop DSA positivity, IgG subclass testing may indicate how eminent his/her graft failure ensue. Moving forward, we should focus monitoring and treating at first detection of persistent antibodies. This may be the only reasonable way to have significant impact on long-term allograft survival.
支持HLA抗体作为移植生物标志物的证据很充分。越来越清楚的是，这些患者代表了一种新的患者表型，他们迅速进展为慢性损伤的风险最高。因此，通过系列筛查早期发现这些高危患者是必要的。此外，一旦患者出现供者特异性抗体（DSA）阳性，IgG亚类检测可能表明其移植失败的紧迫性。展望未来，我们应在首次检测到持续性抗体时就重点进行监测和治疗。这可能是对长期移植物存活产生重大影响的唯一合理方法。
