National Heart and Lung Institute, Imperial College, Harefield Hospital, London, United Kingdom.
Transplantation. 2012 Feb 15;93(3):244-6. doi: 10.1097/TP.0b013e31823f468c.
The term "accommodation" was invoked to describe endothelial cell resistance to antibody-mediated rejection after ABO-incompatible kidney or experimental xenograft transplantation. Currently, there is much interest in how to achieve successful human leukocyte antigen (HLA)-incompatible allograft transplantation in HLA-sensitized patients and how to treat antibody-mediated rejection after ABO-compatible HLA-incompatible allotransplantation. The term "accommodation" is often used interchangeably to describe patients who have donor-specific ABO or HLA alloantibodies in the absence of damage to their allograft. Here, we suggest that there are important differences between the immune responses to protein versus carbohydrate antigens and that graft HLA molecules may respond differently to antibodies (and antibody isotypes) than ABO antigens. Neither the mechanisms nor a phenotype of accommodation have been defined fully. Further research is needed to define mechanisms of both resistance and susceptibility to antibody-mediated injury and to predict under which circumstances allograft accommodation may occur.
“适应”一词被用来描述 ABO 不相容肾或实验性异种移植物移植后内皮细胞对抗体介导排斥的抵抗力。目前，人们非常关注如何在 HLA 致敏患者中实现成功的人类白细胞抗原（HLA）不相容同种异体移植，以及如何治疗 ABO 相容 HLA 不相容同种异体移植后的抗体介导排斥。“适应”一词常被用来描述在没有移植物损伤的情况下具有供体特异性 ABO 或 HLA 同种抗体的患者。在这里，我们建议，蛋白质与碳水化合物抗原的免疫反应之间存在重要差异，并且移植物 HLA 分子可能对抗体（和抗体同种型）的反应不同于 ABO 抗原。适应的机制和表型尚未完全确定。需要进一步的研究来确定对抗体介导损伤的抵抗和易感性的机制，并预测在何种情况下可能发生同种异体移植物适应。
