Davis Scott, Cooper James E
Division of Renal Disease and Hypertension, Transplant Center, University of Colorado Denver.
Division of Renal Disease and Hypertension, Transplant Center, University of Colorado Denver.
Transplant Rev (Orlando). 2017 Jan;31(1):47-54. doi: 10.1016/j.trre.2016.10.004. Epub 2016 Oct 10.
Antibody-mediated rejection has now been recognized as one of the most important causes of graft loss. Transplantation across HLA barriers and nonadherence can result in acute antibody-mediated rejection, which is associated with particularly worse graft outcomes. New technologies, including genomic studies and assays to detect and define donor-specific antibodies, have provided important insights into the pathophysiology and diagnosis of acute antibody-mediated rejection but have engendered many questions about the clinical application of these tests in the prognosis and prevention of this protean disease process. In this article, we review the pathophysiology of acute antibody-mediated rejection, the evolving diagnostic criteria, and specific challenges related to its prognosis, treatment, and prevention.
抗体介导的排斥反应现已被公认为移植物丢失的最重要原因之一。跨越人类白细胞抗原（HLA）屏障的移植和不依从性可导致急性抗体介导的排斥反应，这与特别差的移植物结局相关。包括基因组研究以及检测和鉴定供体特异性抗体的检测方法在内的新技术，为急性抗体介导的排斥反应的病理生理学和诊断提供了重要见解，但也引发了许多关于这些检测在这种多变的疾病过程的预后和预防中的临床应用的问题。在本文中，我们综述了急性抗体介导的排斥反应的病理生理学、不断演变的诊断标准以及与其预后、治疗和预防相关的具体挑战。
