组织限制性非HLA抗体介导的人肺同种异体移植体液性排斥反应
Humoral Human Lung Allograft Rejection by Tissue-Restricted Non-HLA Antibodies.
作者信息
Fernandez Ramiro, Chiu Stephen, Raparia Kirtee, Garcha Puneet, Farver Carol, Budev Marie, Tambur Anat R, DeCamp Malcolm M, Budinger Scott, Perlman Harris, Mohanakumar T, Bharat Ankit
机构信息
Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Cleveland Clinic Foundation, Cleveland, Ohio.
出版信息
Ann Thorac Surg. 2016 Oct;102(4):e339-41. doi: 10.1016/j.athoracsur.2016.03.042.
Abstract
A third of lung recipients have preexisting antibodies against nonhuman leukocyte self-antigens (nHAbs) present in the lung tissue. These nHAbs also form de novo in about 70% of patients within 3 years after transplantation. Both preexisting and de novo nHAbs can cause murine lung allograft dysfunction. However, their role in human transplantation remains unclear. We report hyperacute rejection after right lung transplant in a recipient with preexisting nHAbs. The recipient of the left lung from the same donor had an uneventful initial course, but de novo nHAbs developed at 3 weeks, leading to acute humoral rejection. Both patients were successfully treated with antibody-directed therapies.
摘要
三分之一的肺移植受者体内预先存在针对肺组织中存在的非人类白细胞自身抗原（nHAbs）的抗体。这些nHAbs在移植后3年内也会在约70%的患者体内重新形成。预先存在的和新形成的nHAbs均可导致小鼠肺同种异体移植功能障碍。然而，它们在人类移植中的作用仍不清楚。我们报告了一名预先存在nHAbs的受者在右肺移植后发生超急性排斥反应。来自同一供体的左肺受者初始病程平稳，但在3周时出现了新形成的nHAbs，导致急性体液排斥反应。两名患者均通过抗体导向治疗成功治愈。
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