Cedars-Sinai Heart Institute, Los Angeles, California, USA.
Curr Opin Organ Transplant. 2020 Jun;25(3):248-254. doi: 10.1097/MOT.0000000000000754.
The present article will review the diagnosis of antibody-mediated rejection in heart transplant recipients and further explore the clinical implications.
Improved diagnostic techniques have led to increased recognition of antibody-mediated rejection and better understanding of the long-term consequences in heart transplant recipients. Endomyocardial biopsy remains the gold standard for the diagnosis of antibody-medicated ejection; however, several advances in molecular testing have emerged, including the use of gene expression profiling, messenger RNA, and microRNA. Routine surveillance of donor-specific antibodies identifies recipients at high risk for graft compromise. Additionally, new monoclonal antibody therapies have broadened our repertoire in the treatment of rejection.
Advances in molecular testing for antibody-mediated rejection may improve the associated long-term complication, while minimizing risk to the patient.
本文将回顾心脏移植受者抗体介导排斥反应的诊断，并进一步探讨其临床意义。
诊断技术的改进提高了对抗体介导排斥反应的认识，加深了对心脏移植受者长期后果的理解。心内膜心肌活检仍然是诊断抗体介导排斥反应的金标准；然而，分子检测方面出现了一些进展，包括基因表达谱、信使 RNA 和 microRNA 的应用。常规监测供体特异性抗体可识别出移植物受损风险较高的受者。此外，新型单克隆抗体治疗拓宽了我们在排斥反应治疗中的手段。
分子检测技术在抗体介导排斥反应方面的进步可能改善相关的长期并发症，同时降低对患者的风险。
