Patel Jignesh K
Smidt Cedars-Sinai Heart Institute, 127 S San Vicente Blvd, Los Angeles, CA 90048 USA.
Indian J Thorac Cardiovasc Surg. 2020 Aug;36(Suppl 2):194-199. doi: 10.1007/s12055-020-00928-x. Epub 2020 Mar 2.
The development of effective immunosuppressive strategies has been a key to successful outcomes in heart transplantation. Immunosuppression however is a double-edged sword with consequences of rejection when underutilized and risk for infection, malignancy, and drug toxicity when used in excess. The search for non-invasive blood-based monitoring not only to assess allograft rejection but also to monitor overall state of immunosuppression remains very attractive, potentially reducing cost and complications and allowing more frequent testing to assess response to anti-rejection therapy. This review outlines the current status of blood-based immunological monitoring after heart transplantation including serological monitoring, biomarkers, and evolution of molecular technologies.
有效的免疫抑制策略的发展一直是心脏移植成功结果的关键。然而，免疫抑制是一把双刃剑，使用不足会导致排斥反应，使用过度则会有感染、恶性肿瘤和药物毒性的风险。寻找不仅能评估移植器官排斥反应，还能监测免疫抑制整体状态的非侵入性血液监测方法仍然非常有吸引力，这可能会降低成本和并发症，并允许更频繁地进行检测以评估抗排斥治疗的反应。本综述概述了心脏移植后基于血液的免疫监测的现状，包括血清学监测、生物标志物和分子技术的发展。
