Frandsen Erik L, Albers Erin L
Division of Pediatric Cardiology, Seattle Children's Hospital, Seattle, Washington, USA.
Transl Pediatr. 2019 Oct;8(4):302-313. doi: 10.21037/tp.2019.07.13.
Despite advancements in transplant immunosuppression and techniques for managing critically ill patients awaiting heart transplantation, children who are immunologically sensitized to human leukocyte antigen remain at increased risk for morbidity and mortality, both while awaiting and after heart transplant. In this review we will discuss the epidemiology of sensitization, review the immunologic basis and methods of human leukocyte antigen antibody detection, describe outcomes for sensitized pediatric transplant candidates, and consider both pre- and post-transplant management options for sensitized patients.
尽管在移植免疫抑制以及管理等待心脏移植的重症患者的技术方面取得了进展，但对人类白细胞抗原产生免疫致敏的儿童，在等待心脏移植期间以及移植后，发病和死亡风险仍然较高。在本综述中，我们将讨论致敏的流行病学，回顾人类白细胞抗原抗体检测的免疫学基础和方法，描述致敏儿科移植候选者的预后，并考虑致敏患者移植前和移植后的管理方案。
