Abbes Sarah, Metjian Ara, Gray Alice, Martinu Tereza, Snyder Laurie, Chen Dong-Feng, Ellis Matthew, Arepally Gowthami M, Onwuemene Oluwatoyosi
Institut du thorax, Service de pneumologie et unite de transplantation thoracique, Centre Hospitalier Universitaire, Nantes, France.
Department of Medicine, Division of Hematology, Duke University School of Medicine, Durham, NC, USA.
Ther Apher Dial. 2017 Oct;21(5):441-450. doi: 10.1111/1744-9987.12570. Epub 2017 Sep 7.
The human leukocyte antigen (HLA) system is an important immunologic barrier that must be considered for successful solid organ transplantation. Formation of donor-specific HLA antibodies in solid organ transplantation is an important cause of allograft injury and may contribute to recipient morbidity and mortality. Therapeutic plasma exchange is often requested to lower HLA antibody levels prior to or after transplantation and for management of HLA antibodies in the context of organ rejection. In this review, we summarize the current terminology, laboratory testing, and clinical significance of HLA sensitization in the solid organ transplant population. Furthermore, to illustrate applications of HLA testing in clinical practice, we summarize our own lung and kidney institutional protocols for managing HLA antibodies in the peri-transplant setting.
人类白细胞抗原（HLA）系统是成功进行实体器官移植时必须考虑的重要免疫屏障。实体器官移植中供体特异性HLA抗体的形成是同种异体移植物损伤的重要原因，可能导致受者发病和死亡。治疗性血浆置换常用于在移植前或移植后降低HLA抗体水平，以及在器官排斥反应的情况下管理HLA抗体。在本综述中，我们总结了实体器官移植人群中HLA致敏的当前术语、实验室检测和临床意义。此外，为了说明HLA检测在临床实践中的应用，我们总结了我们自己机构用于在移植围手术期管理HLA抗体的肺和肾方案。
