Niaudet P
Hôpital Necker Enfants Malades, Paris, France.
Intensive Care Med. 1989;15 Suppl 1:S61-3. doi: 10.1007/BF00260890.
Several immunological factors affect the outcome of human kidney transplants. HLA-A, -B and -DR matching improves kidney graft survival rate, especially matching for HLA-DR antigens. The beneficial effect of pretransplant blood transfusion has been confirmed although the mechanisms of the beneficial effect are not clear. Donor specific transfusion prior to living related donor kidney transplantation improve graft survival but some 30% of potential recipients become sensitized to the donor during the transfusion process. Major improvements in the results of organ transplantation have been achieved during the past few years with the use of new immunosuppressive agents, namely cyclosporin and monoclonal antibodies reacting with T lymphocytes. Both agents act selectively on T lymphocytes. However, nephrotoxicity of cyclosporin may limit its use.
多种免疫因素影响人类肾移植的结果。HLA - A、- B和 - DR配型可提高肾移植存活率，尤其是HLA - DR抗原的配型。尽管输血有益作用的机制尚不清楚，但移植前输血的有益作用已得到证实。亲属活体供肾移植前的供体特异性输血可提高移植存活率，但约30%的潜在受者在输血过程中会对供体产生致敏。在过去几年中，通过使用新型免疫抑制剂，即环孢素和与T淋巴细胞反应的单克隆抗体，器官移植的结果有了重大改善。这两种药物都选择性地作用于T淋巴细胞。然而，环孢素的肾毒性可能会限制其使用。
