Malvezzi Paolo, Jouve Thomas, Noble Johan, Rostaing Lionel
From the Service de Néphrologie, Hémodialyse, Aphérèses et Transplantation, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France.
Exp Clin Transplant. 2018 Aug;16(4):367-375. doi: 10.6002/ect.2017.0355. Epub 2018 Jun 1.
The number of kidney transplant candidates is increasing sharply. Among them, at least 20% are HLA sensitized. For these patients, in the setting of both living- and deceased-donor kidney transplant, we may face donor-specific alloantibodies at pretransplant. In such cases, the microlymphocytotoxicity crossmatch may or may not be positive. Kidney transplant with donor-specific antibodies at pretransplant is known as HLA-incompatible transplant. At present, we can use many methods to ensure that the kidney transplant is successful, provided that the recipient is desensitized before or after transplant. In this paper, we review the various strategies available for desensitization of HLA-incompatible kidney transplant recipients and the long-term outcomes.
肾移植候选者的数量正在急剧增加。其中，至少20%是HLA致敏的。对于这些患者，在活体供肾和尸体供肾肾移植中，我们在移植前可能会面临供者特异性同种抗体。在这种情况下，微量淋巴细胞毒性交叉配型可能为阳性，也可能为阴性。移植前存在供者特异性抗体的肾移植被称为HLA不相容移植。目前，只要在移植前或移植后使受者脱敏，我们可以使用多种方法确保肾移植成功。在本文中，我们综述了HLA不相容肾移植受者脱敏的各种可用策略及其长期预后。
